[7] While initially limited to a subset of vertebrates (i.e. human, cow, cat, dog, chicken, guinea pig, hamster, mouse, pig, rabbit, sheep, and Xenopus), subsequent studies confirmed its conservation in higher eukaryotes generally.
[1] The sequence was defined as 5'-(gcc)gccRccAUGG-3' (IUPAC nucleobase notation summarized here) where:[7] The AUG is the initiation codon encoding a methionine amino acid at the N-terminus of the protein.
Kozak sequence strength refers to the favorability of initiation, affecting how much protein is synthesized from a given mRNA.
[4][9] The A nucleotide of the "AUG" is delineated as +1 in mRNA sequences with the preceding base being labeled as −1, i.e. there is no 0 position.
This recruitment to the m7G 5′ cap is supported by the inability of eukaryotic ribosomes to translate circular mRNA, which has no 5′ end.
[19] Upon base pairing to the start codon the eIF5 in the PIC helps to hydrolyze a guanosine triphosphate (GTP) bound to the eIF2.
In contrast, scanning along the mRNA results in a more rigorous selection process for the AUG codon than in bacteria.
[29][30] Research has shown that a mutation of G—>C in the −6 position of the β-globin gene (β+45; human) disrupted the haematological and biosynthetic phenotype function.
[4] Similar observations were made regarding mutations in the position −5 from the start codon, AUG. Cytosine in this position, as opposed to thymine, showed more efficient translation and increased expression of the platelet adhesion receptor, glycoprotein Ibα in humans.
[34] When the guanosine at the -6 position in the Kozak sequence of GATA4 is mutated to a cytosine, a reduction in GATA4 protein levels results, which leads to a decrease in the expression of genes regulated by the GATA4 transcription factor and linked to the development of atrial septal defect.
[35] The ability of the Kozak sequence to optimize translation can result in novel initiation codons in the typically untranslated region of the 5′ (5′ UTR) end of the mRNA transcript.
A G to A mutation was described by Bohlen et al. (2017) in a Kozak-like region in the SOX9 gene that created a new translation initiation codon in an out-of-frame open reading frame.
The patient in whom this mutation was detected had developed acampomelic campomelic dysplasia, a developmental disorder that causes skeletal, reproductive and airway issues due to insufficient SOX9 expression.