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Enzyme Critical for Early Growth of Abdominal Aortic Aneurysms

Surgery is the only treatment for an abdominal aortic aneurysm, a weak spot in the body's main artery that dilates dangerously// over time. If the vessel ruptures suddenly before surgery to repair it, a quick death is virtually certain. Now, scientists say they have identified a key enzyme that triggers chronic inflammation in the aorta and promotes the growth of aneurysms. Their finding raises hopes for developing a drug that could prevent small aneurysms from enlarging to the point where surgery is necessary.

Genetically engineered mice that lack the enzyme dipeptidyl peptidase I (DPPI) do not develop aortic aneurysms, researchers at Washington University School of Medicine in St. Louis report in the online edition of the Proceedings of the National Academy of Sciences U.S.A. 'We think DPPI is a viable therapeutic target that may keep the growth of aortic aneurysms in check, so they don't become life threatening,' says Robert W. Thompson, M.D., professor of surgery and one of the senior investigators on the article.

The new research shows that DPPI is critical for the recruitment of inflammatory cells to the aortic wall, and that these cells push the inflammation from an acute phase into a chronic phase. The researchers suspect that this chronic inflammation eventually causes other enzymes to eat away at the structural proteins of the aorta, causing the vessel to balloon slowly and ultimately rupture in patients whose aortas are greatly distended.

Abdominal aortic aneurysms kill about 15,000 Americans each year and have claimed the lives of such notables as Albert Einstein and Lucille Ball. The condition often goes undiagnosed because small aneurysms rarely cause symptoms. Typically, they are discovered by accident when patients have an X-ray or ultrasound for another medical concern.

If an aneurysm is small, doctors generally monitor it closely and recommend surgery only if its diameter grows larger than 5.5 centime
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