Cathepsin K

Cathepsin K (CTSK) is the cathepsin family member most closely associated with skeletal biology, where it is highly and preferentially expressed in osteoclasts. It is the dominant protease responsible for degradation of type I collagen and other bone matrix components during bone resorption, an activity supported by its potent collagenase capability that distinguishes it from most other cysteine cathepsins. Because of this specialization, CTSK inhibitors were developed as antiresorptive drugs for osteoporosis. Biallelic loss-of-function mutations in CTSK cause pycnodysostosis, a rare autosomal recessive skeletal dysplasia characterized by osteosclerosis, short stature, and bone fragility, and the enzyme has also been implicated in cartilage degradation in osteoarthritis.