Immunosuppression and the Abdominal Aortic Aneurysm

L arger abdominal aortic aneurysms (AAAs) have a high propensity to rupture, which makes them a significant health problem.As a result, elective repair is generally recommended.However, the great majority of AAAs are small and do not establish such a risk, in particular, not if the growth of small AAAs is absent.It has been pointed out that pharmaceutical interventions, which stabilize small AAAs and thus reduce the need for surgical repair, could be highly beneficial. 1 Yet, the most effective strategies still have to be identified.The pathology of larger AAAs is complex and best described as a general proinflammatory response and an accompanying proteolytic imbalance, the latter being held responsible for the excess matrix turnover in the disease.The inflammatory fingerprint of the larger AAA is multifaceted and is characterized by marked interleukin (IL) 6 and IL-8 hyperexpression, 2 and by a comprehensive cellular infiltrate that includes ample macrophages, B cells, T cells, plasma cells, neutrophils, mast cells, and other cell types. 3Yet,