Objective-To determine whether procarboxypeptidase B (pCPB)Ϫ/Ϫ mice are susceptible to accelerated abdominal aortic aneurysm (AAA) development secondary to unregulated OPN-mediated mural inflammation in the absence of CPB inhibition. Methods and Results-Thrombin/thrombomodulin cleaves thrombin-activatable pCPB or thrombin-activatable fibrinolysis inhibitor, activating CPB, which inhibits the generation of plasmin and inactivates proinflammatory mediators (complement C5a and thrombin-cleaved osteopontin [OPN] Key Words: thrombosis Ⅲ abdominal aortic aneurysm Ⅲ carboxypeptidase Ⅲ osteopontin Ⅲ plasmin A bdominal aortic aneurysm (AAA) is a common and potentially lethal disease, found in approximately 6% to 8% of men older than 60 years. AAA rupture is the most serious consequence of the disease and accounts for approximately 15 000 deaths in the United States annually. 1,2 The pathogenesis of AAA disease is complex, involving chronic transmural inflammation, characterized by macrophage and lymphocyte infiltration and proteolytic degradation of medial elastin and interstitial collagens by matrix metalloproteinases (MMPs). Structural degradation of the aortic wall in combination with hemodynamic stress results in tissue failure and aneurysmal dilatation. 3 Osteopontin (OPN) is a multifunctional protein that is both a component of the extracellular matrix (ECM) in mineralized tissues and a circulating proinflammatory cytokine. 4 OPN is a prominent component of human atherosclerotic tissues and has recently been demonstrated to play a key role in AAA pathogenesis. 5 Compared with apolipoprotein E (ApoE) Ϫ/Ϫ mice, ApoE Ϫ/Ϫ OPN Ϫ/Ϫ double-knockout mice are protected from angiotensin II-induced accelerated atherosclerosis and AAA formation. 6 Structurally, OPN contains an RGD site (159 -161) that mediates binding to a number of integrins, including ␣v1, ␣v3, ␣v5, and ␣51. Thrombin cleavage of OPN exposes a hitherto cryptic C-terminus ( 162 SVVYGLR 168 ) that mediates the binding of thrombincleaved OPN (OPN-R) to a new subset of integrins, consisting of ␣41 and ␣91. 7-9 OPN-R demonstrates enhanced cell binding and cell migration compared with intact OPN in vitro, 10,11 suggesting that thrombin cleavage of OPN may augment its proinflammatory properties.When thrombin binds to thrombomodulin on the endothelial cell surface, it undergoes a remarkable change in its substrate recognition, switching from procoagulant factors, such as fibrinogen, to protein C and functionally inhibiting progressive thrombosis. 12 In addition to inhibiting coagulation via the activation of protein C, the thrombinthrombomodulin complex also influences fibrinolysis by activating a second physiological substrate, the plasma carboxypeptidase, thrombin-activatable procarboxypeptidase B (pCPB), or thrombin-activatable fibrinolysis inhibitor. 13,14