In summary, our study demonstrates that the combination of specific factors known to induce aneurysm growth exhibits a synergistic effect on AAA development by enhancing inflammation, MMP activation, elastin fiber degradation, and ILT formation – closely mirroring human disease characteristics.26,27 First, we demonstrated that peri-adventitial exposure to a combination of papain and PPE, significantly influences AAA expansion, histopathology, and inflammation over a 14-day period. Here, ELN is linked to triple-A syndrome.