RPL23 is a structural component of the cytosolic 60S ribosomal subunit essential for protein synthesis 1. Beyond its canonical ribosomal role, RPL23 functions in cellular signaling and disease pathology. The snoRNA SNORA13 directly interacts with RPL23, regulating its incorporation into maturing 60S subunits; free RPL23 accumulation triggers p53-mediated senescence 2. In triple-negative breast cancer, the U2AF2-SNORA68 complex retains RPL23 in the nucleolus, promoting c-Myc expression and cancer stemness 3. In myelodysplastic syndrome, RPL23 overexpression suppresses apoptosis through the RPL23/Miz-1/c-Myc regulatory circuit, reducing expression of cell cycle inhibitors p15Ink4b and p21Cip1 4. RPL23 is also an autoimmune target; T cells and autoantibodies from rheumatoid arthritis patients recognize RPL23A 5. Genome-wide association studies associate RPL23 variants with Alzheimer's disease risk 6, and RPL23 protein levels are significantly upregulated in AD brain capillaries, correlating with enhanced protein processing and N-glycosylation 7. These findings reveal RPL23 as a multifunctional protein with roles in ribosome assembly, senescence, cancer stemness, autoimmunity, and neurodegeneration.