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#Cardiology #Nephrology #Transplantation
A new article published in Frontiers in Cardiovascular Medicine reported that cardiovascular disease (CVD) is responsible for a majority of deaths, especially in patients with chronic kidney disease (CKD). Among these patients, the imbalance of calcium and phosphate may lead to the acceleration of both vascular and valve inflammation and calcification. It was stated that one out of two patients with CKD have been reported as dying from cardiovascular causes, due to the consequent acceleration in the development of atherosclerosis plaques. Meanwhile, CKD patients on hemodialysis are prone to aortic valve calcification and need valve replacement prior to kidney transplantation. This article elaborated that the lysosomal proteases, cathepsins, are composed of 11 cysteine members (cathepsin B, C, F, H, K, L, O, S, V, W, and Z), as well as serine proteases cathepsin A and G, which cleave peptide bonds with serine as the amino acid, and aspartyl proteases D and E, which in turn, use an activated water molecule bound to aspartate to break peptide substrate. Cysteine proteases, also known as thiol proteases, degrade protein through the deprotonation of a thiol and have been found to play a major part in autoimmune disease, atherosclerosis, aortic valve calcification, cardiac repair, and cardiomyopathy, by means of operating within extracellular spaces. This article described the mechanism by which the inhibition of cathepsin S could play a significant role in diminishing the effects of CVD in patients with CKD.