Cysteine cathepsins are involved in protein degradation (1) and the development and function of the immune system (2). Cathepsin L is an endopeptidase that is able to perform limited proteolysis in the endosomes and lysosomes of specific cell types. Besides its role in hair formation and skin metabolism, it is involved in T-cell selection and NKT cell development (3). It participates in processing the major histocompatibility complex II invariant chain in thymic cortex epithelial cells (4), encephalin in chromaffin granules of neuroendocrine cells (5), and in the degradation and recycling of growth factors and their receptors in epidermal keratinocytes (6). Cathepsin L is also associated with an endosomal processing step during invasion of cells by Ebola virus (7), severe acute respiratory syndrome (SARS) coronavirus (8), and murine hepatitis coronavirus (9). As the result of gene duplication, the human genome encodes for two cathepsin L-like proteases, namely the human cathepsin L and cathepsin V (cathepsin L2), whereas in mouse only cathepsin L is present (10). At the protein level, mouse cathepsin L displays a higher sequence homology to human cathepsin V than to human cathepsin L (11). Cathepsin V shares 80% protein sequence identity with cathepsin L, but in contrast to the ubiquitously expressed cathepsin L, its expression is restricted to thymus and testis (11,12).Recently, the otherwise endosomal proteinase cathepsin L has been reported to be active in the nucleus. It cleaves the CUX1 transcription factor and as a result accelerates progression into the S phase of the cell cycle (13). Cathepsin L deficiency was shown to cause a global rearrangement of chromatin structure and redistribution of specifically modified histones (14). In addition, cathepsin L was found to cleave histone H3.2 in the nucleus during mouse embryonic stem cell differentiation (15).Cathepsin L is inhibited in vitro by a number of proteins as follows: cystatins (16), thyropins (17), and some of the serpins (18,19). Type 1 cystatins, or stefins, are mainly intracellular, whereas type 2 cystatins are predominantly secreted (20,21). Stefin B is localized in the cytosol and nucleus of proliferating cells (22). Loss-of-function mutations in the cystatin B (CTSB, stefin B) gene are found in patients with Unverricht-Lundborg disease (EPM1), but its physiological implication in the pathogenesis of the disease has yet to be defined (23-26). EPM1 is an autosomal recessive inherited disease in which patients suffer from myoclonic jerks, tonic-clonic epileptic seizures, and progressive decline in cognition (26). Histopathological examination of the brain has shown neural degeneration in several areas of the central nervous system, with cerebellar damage and serious alterations of Purkinje cells (27). The most common mutation in EPM1 patients is a dodecamer repeat expansion in the stefin B (CSTB) gene promoter region that leads to reduced mRNA and protein levels (23,25). In addition, four mutations in the coding region were reported in EPM1 (23,28...