“…In addition, since distinct mRNA isoforms may differ in their translational efficiency, regulation of promoter choice may impact gene expression at the protein level. In some instances, this difference in translational efficiency is due to the presence of upstream ORFs (uORFs) in the 5' leader of the distal promoter-derived mRNA isoform, which could inhibit translation of the protein-coding ORF (Moseley et al, 2002;Law et al, 2005;Sehgal et al, 2008;Ingolia et al, 2011;Rojas-Duran and Gilbert, 2012;Brar et al, 2012;Chew et al, 2016;Bird and Labbé, 2017;Chen et al, 2017;Cheng et al, 2018;Zhang et al, 2018) . As a result, in these cases, transcription of a distal promoter-derived mRNA isoform causes downregulation of protein expression through the integration of two seemingly disparate mechanisms of transcriptional and translational repression Cheng et al, 2018;Van Dalfsen et al, 2018;Hollerer et al submitted).…”