Cathepsins are involved in many physiological processes and have been implicated in a number of human diseases. The
cysteine cathepsins have attracted significant research effort as
drug targets. •
Cancer, Cathepsin D is a
mitogen and "it attenuates the anti-tumor immune response of decaying chemokines to inhibit the function of dendritic cells". Cathepsins B and L are involved in matrix degradation and cell invasion. •
Stroke •
Traumatic brain injury •
Alzheimer's disease •
Arthritis •
Ebola, Cathepsin B and to a lesser extent cathepsin L have been found to be necessary for the virus to enter host cells. •
COPD •
Chronic periodontitis •
Pancreatitis • Several ocular disorders:
keratoconus,
retinal detachment,
age-related macular degeneration, and
glaucoma.
Cathepsin A Deficiencies in this protein are linked to multiple forms of
galactosialidosis. The cathepsin A activity in
lysates of metastatic lesions of
melanoma is significantly higher than in primary focus lysates. Cathepsin A increased in muscles moderately affected by muscular dystrophy and denervating diseases.
Cathepsin B Cathepsin B may function as a
beta-secretase 1, cleaving
amyloid precursor protein to produce
amyloid beta. Overexpression of the encoded protein, which is a member of the peptidase C1 family, has been associated with
esophageal adenocarcinoma and other tumors. Cathepsin B has also been implicated in the progression of various human tumors High levels of this enzyme in tumor cells seems to be associated with greater invasiveness.
Cathepsin K Cathepsin K is the most potent mammalian
collagenase. Cathepsin K is involved in
osteoporosis, a disease in which a decrease in bone density causes an increased risk for fracture.
Osteoclasts are the bone resorbing cells of the body, and they secrete cathepsin K in order to break down
collagen, the major component of the non-mineral protein matrix of the bone. Cathepsin K, among other cathepsins, plays a role in cancer metastasis through the degradation of the extracellular matrix. The genetic knockout for cathepsin S and K in mice with atherosclerosis was shown to reduce the size of atherosclerotic lesions. The expression of cathepsin K in cultured endothelial cells is regulated by
shear stress. Cathepsin K has also been shown to play a role in arthritis.
Cathepsin V Mouse cathepsin L is homologous to human cathepsin V. Mouse cathepsin L has been shown to play a role in adipogenesis and glucose intolerance in mice. Cathepsin L degrades fibronectin,
insulin receptor (IR), and
insulin-like growth factor 1 receptor (IGF-1R). Cathepsin L-deficient mice were shown to have less adipose tissue, lower serum glucose and insulin levels, more insulin receptor subunits, more
glucose transporter (GLUT4) and more fibronectin than wild type controls.
Inhibitors Five cyclic peptides show inhibitory activity towards human cathepsins L, B, H, and K. Several inhibitors have reached
clinical trials, targeting cathepsins K and S as promising therapeutics for
osteoporosis,
osteoarthritis, and
chronic pain. Cathepsin K inhibitors, Relacatib, Balicatib, and Odanacatib, were terminated during clinical trials at phases I, II, and III, respectively, owing to adverse side effects. SAR114137, a Cathepsin S inhibitor, did not progress past phase I for chronic pain. In 2022,
STI-1558, a Cathepsin L inhibitor, received
FDA clearance to begin phase I studies to treat
COVID-19. ==Cathepsin zymography==