Model of GATA1 downregulation through the combined effects of p53 and TNF-α in RPS19-deficient cells. Deficiency of RPS19 in hematopoietic progenitors leads to ribosomal stress, which increases p53 levels as well as inflammation, which increases production of TNF-α by nonerythroid cells. TNF-α represses GATA1 through activation of p38 MAPK and may also contribute to increased p53 levels, which results in reduced survival and differentiation of erythroid cells.