Role of the 90 kDa ribosomal s6 kinases (p90RSK), one of the downstream mediators of extracellular signal-regulated kinase (ERK) pathway, in diseases. When the receptor tyrosine kinase (RTK, green) gets activated by a ligand (purple), it stimulates the activation of the docking proteins growth factor receptor-bound protein 2 (GRB2) and son of sevenless (SOS). SOS helps remove the guanosine diphosphate (GDP) from Rat sarcoma (Ras), allowing it to bind guanosine triphosphate (GTP) and become activated. The Ras signalling cascade begins as Ras activates the Raf kinase, which phosphorylates mitogen-activated protein kinase kinase (MEK1/2), extracellular signal-regulated kinase 1/2 (ERK1/2) and p90RSK. Then p90RSK phosphorylates various downstream substrates (blue) to mediate diverse cellular processes (purple) and contribute to numerous human diseases including kidney disease, cardiovascular disease and cancer (red).