Higher levels of transcripts from the genes encoding the BCL interacting protein 3 like protein (BNIP3L) which is involved in activation and assembly of the apoptosome protein complex domains54, cathepsin B (CTSB) which is involved in lysosomal protein degradation, processing and presentation as well as extracellular matrix degradation55, and myeloperoxidase (MPO) which is involved in reactive oxygen species production56,57 were observed in podoconiosis patients compared to healthy controls. This evidence concerns the gene CTSB and podoconiosis.