Objective-In human abdominal aortic aneurysm, the accumulation of blood-derived cells and proteases within the mural thrombus plays a pivotal role in the evolution toward vessel wall rupture. We sought to identify peptides released from abdominal aortic aneurysm specimens, characterized by an intraluminal thrombus. Methods and Results-Intraluminal thrombus samples were analyzed by differential proteomics, using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. A 1309-Da peptide was detected in larger amounts in the newly formed luminal thrombus layer relative to older layers. It was identified as being LVVYPWTQRF (known as LVV-Hemorphin 7), a peptide generated from hemoglobin by cathepsin D. By immunohistochemical analysis, we showed that Hemorphin 7 (H7) colocalizes with cathepsin D and cathepsin G in the luminal layer of the intraluminal thrombus. In vitro, cathepsin G was able to generate H7 peptides at pH 7.4, whereas cathepsin D was only active in acidic conditions. Finally, H7 peptides were shown to be increased 3-to 4-fold in sera of abdominal aortic aneurysm patients relative to controls, and their levels were positively correlated with the volume of the thrombus. Key Words: Human atherothrombosis Ⅲ cathepsin G Ⅲ cathepsin D Ⅲ circulating biomarker Ⅲ thrombus I n human atherothrombosis, the accumulation of bloodderived cells and zymogens contributes to oxidation and proteolysis, together leading to arterial wall destabilization. 1 Depending on the arterial territory, complications associated with atherosclerosis may evolve toward stenosis, frequent in carotid, coronary, and femoral arteries, or outward remodeling, mainly in the aorta. In abdominal aorta, where atherothrombosis frequently develops, evolution toward aneurysm is characterized by the presence of a dynamic intraluminal mural thrombus (ILT), which represents a source of blood-borne proteases participating in extracellular matrix degradation and smooth muscle cell apoptosis, preventing thrombus colonization and cicatrization. 2,3 In the present study, we aimed to look for biomarkers reflecting the pathological remodeling of aortic atherothrombosis associated with the thrombus in abdominal aortic aneurysm (AAA). For this purpose, we used a differential proteomics approach comparing the different layers of human AAA samples, including the thrombus, and the remaining media. We used surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS), a particularly well-suited technology for detection of peptides and small proteins, including proteolytic fragments. Our hypothesis is that the proteases conveyed by leukocytes (matrix metalloproteases, elastase, cathepsins, etc) or those generated in situ (ie, plasmin, thrombin) may produce protein fragments reflecting the pathological vascular remodeling. 4 Our strategy was thus to compare the profiles of low-molecular-weight proteins and peptides released by AAA samples. Such peptides could be used as biomarkers of the thrombus activity and an...