Pachyonychia congenita (PC) is a keratinizing disorder predominantly caused by mutations in
keratin 6a (K6a) (∼50% of cases) or K6b, K16, or K17. One means of treating PC is identification of small-molecule inhibitors of PC-related
keratins. Here, we cloned the human K6a promoter, and using a cell-based reporter gene assay, a chemical library was screened for K6a inhibitors. One compound,
compactin, the precursor of all
cholesterol-lowering
statins, was of particular interest. We found that, surprisingly,
simvastatin and other
statins inhibit K6a promoter activity and K6a
protein expression. Further investigation showed that this effect works through
cholesterol/
mevalonate pathway inhibition rather than an off-target effect. Inhibition of both basal and IFN-γ-inducible K6a expression by
statins was demonstrated. Both these K6a inhibitory effects were found to be mediated by
Stat1 transcription factor, but only the IFN-γ-inducible promoter activity was controlled via the Stat/JAK pathway. The repressive effect of
statins was found to be mediated by the
isoprenoid pathway downstream of
mevalonate (the intermediate following 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase) but upstream of
cholesterol, specifically the geranylgeranylation pathway. These data set the scene for further unraveling signaling pathways that control the K6a promoter, as well as facilitating clinical trials for
statins in PC patients.