CELA2A encodes a circulating serine-type endopeptidase with dual roles in glucose metabolism and platelet regulation 1. As a pancreatic elastase, CELA2A enhances insulin signaling by triggering both insulin secretion and degradation while increasing insulin sensitivity 1. The enzyme circulates in plasma with postprandial elevation paralleling insulin levels, reducing platelet hyperactivation 1. Loss-of-function CELA2A mutations predispose to early-onset atherosclerosis and metabolic syndrome, highlighting its protective role in cardiometabolic health 1. Genetically predicted elevated circulating CELA2A protects against Alzheimer's disease pathogenesis 2. In pancreatic physiology, CELA2A binds weakly to procarboxypeptidase A1 but not A2, unlike the related isoform CELA3B 3. In disease contexts, CELA2A is downregulated in pancreatic ductal adenocarcinoma compared to normal tissue 4. Notably, clinical fecal elastase ELISA tests do not detect CELA2A, instead measuring CELA3 isoforms specifically 56. These findings position CELA2A as a potential therapeutic target for metabolic and neurodegenerative diseases.