title: Dipeptidyl peptidase-4 inhibition: insights from the bench and recent clinical studies.
abstract: Atherosclerosis is the leading cause of death globally. The pathophysiology of atherosclerosis is not fully understood. Recent studies suggest dipeptidyl peptidase-4 (DPP4), a regulator of inflammation and metabolism, may be involved in the development of atherosclerotic diseases. Recent advances in the understanding of DPP4 function in atherosclerosis will be discussed in this review.
  
  
  
  Multiple preclinical and clinical studies suggest DPP4/glucagon-like peptide-1 axis is involved in the development of atherosclerotic disease. However, several recent trials assessing the cardiovascular effects of DPP4 inhibition indicate enzymatic inhibition of DPP4 lacks beneficial effects on cardiovascular disease.
  
  
  
  Catalytic inhibition of DPP4 with DPP4 inhibitors alters pathways that could favor cardioprotection. Glucagon-like peptide-1 receptor-independent aspects of DPP4 function may contribute to the overall neutral effects on cardiovascular outcome seen in the outcome trials.
authors.affiliation: Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA *Jixin Zhong and Sanjay Rajagopalan contributed equally to the writing of this article.
authors.forename: Jixin
authors.initials: J
authors.lastname: Zhong
authors.forename: Saumya
authors.initials: S
authors.lastname: Kankanala
authors.forename: Sanjay
authors.initials: S
authors.lastname: Rajagopalan
mesh_terms: D000818:Animals; D002986:Clinical Trials as Topic; D018819:Dipeptidyl Peptidase 4 / Q000378:metabolism*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000494:pharmacology*; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006801:Humans
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D018819:Dipeptidyl Peptidase 4