In the fullness of time, fairly involved experiments indicated that the reperfusion-induced inhibition of protein synthesis occurred at the level of translation initiation. But how?

Let's start by looking at an overview of the translation initiation process. This is a complex sequence of events involving the participation of over 140 proteins, and culminates in the assembly of the translation intiation complex. Basically, it is the assembly of the small ribosomal subunit, the mRNA and the first amino acid in the form of an animoacyl t-RNA.

First Step: Two views of the translation initation complex.