MRPL51 is a structural component of the mitochondrial large ribosomal subunit (60S) essential for mitochondrial translation 1. As a mitochondrial ribosomal protein, MRPL51 participates in the synthesis of mitochondria-encoded proteins and interacts with the inner membrane insertion machinery, specifically binding to Oxa1L during co-translational insertion of newly synthesized proteins into the inner mitochondrial membrane 1. Clinically, MRPL51 dysregulation is associated with multiple diseases. In Alzheimer's disease, MRPL51 expression changes contribute to a predictive machine learning model (78.1% accuracy) distinguishing AD patients from controls, implicating mitochondrial dysfunction in neurodegeneration 2. In cerebral ischemia-reperfusion injury, MRPL51 knockdown increased cell viability and attenuated apoptosis, suggesting it as a potential therapeutic target 3. MRPL51 dysregulation correlates with poor prognosis in non-small cell lung cancer and represents a biomarker linking musculoskeletal aging and cancer cachexia pathways 4. Additionally, MRPL51 serves as a DNA methylation-related gene in circulating tumor cells of lung adenocarcinoma, contributing to risk stratification for immunotherapy response 5. In premature ovarian insufficiency, MRPL51 is among seven hub mitochondrial genes showing strong correlations with immune infiltration and mitochondrial dysfunction 6.