Role ofChymotrypsin-like Elastase 1in Lung Physiology and in α1-Antitrypsin Deficiency

α1-antitrypsin related lung disease (AAT-RLD) is the fourth leading indication for lung transplantation and is characterized by protease-mediated progressive emphysema that manifests in the 4 th or 5 th decade of life. Chymotrypsin-like elastase 1 ( Cela1 ) is a digestive enzyme that binds to elastin in a stretch-dependent manner and is covalently neutralized by AAT. We hypothesized a role for Cela1 in AAT-RLD. Cela1 -/- mice where phenotypically similar to wild type but had higher lung elastance and lacked stretch-inducible elastase activity. Wild-type mice administered anti-AAT oligo had reduced amounts of lung Cela1-AAT fusion protein in lung homogenate and spontaneously developed emphysema after 6 weeks. Cela1 -/- mice administered anti-AAT oligo were completely protected from these emphysematous changes. Cela1 recombinant protein did not require propeptide cleavage for elastolysis, and its elastolytic profile was similar to that of other pancreatic elastases. Phylogenetic analysis of vertebrate Cela promoter and protein sequences showed that placental mammal Cela1 was distinct from other Cela’s , and that the placental mammal the Cela1 gene was invariantly conserved despite variable loss of other Cela genes in non-carnivores. These data demonstrate that the pancreatic enzyme Cela1 has been evolutionarily co-opted for a role in reducing lung elastance in the placental mammal lineage and that its stretch-regulated expression and elastolytic activity is responsible for emphysema in the absence of its anti-protease: AAT.