PABPN1 and oculopharyngeal muscular dystrophy: Since OPMD is a late-onset disease, it should be noted that heat shock protein levels are decreased with age [47], and our study strongly supports the following hypothetical mechanism: large expansions in PABPN1 recruit more or more rapidly HSP70 which together with a decreased efficiency of refolding with increasing age leads to a decreased bio-availability of HSP70 for the rest of the cell, altering cellular homeostasis and causing overall toxicity.