d-flow-activated PKCζ effects on EC apoptosis. (Upper) d-flow activates PKCζ, which induces activation of E3 SUMO ligase PIASy, SUMOylation of p53, and translocation of p53 to the cytosol where it binds to Bcl-2. Binding between SUMOylated p53 and Bcl-2 results in bax release, which stimulates cytochrome c release from mitochondria, leading to apoptosome formation, caspase activation, and subsequent apoptosis. (Lower) A scheme of the role of localization-dependent p53 on atherosclerosis. (See text for details.)