CTSB and atherosclerosis: Inflammatory cytokines associated with atherosclerosis may alter the relationship between cysteine protease and their endogenous inhibitors like cystatin C. The imbalance of cysteine protease and its inhibitor may increase the degradation of extracellular matrix and migration of monocytes, macrophages and vascular smooth muscle cells into the intima, thus leading to the development of atherosclerosis [34,35].