Niculescu Raluca, Stoian Adina, Arbănași Emil Marian, Russu Eliza, Babă Dragoș-Florin, Manea Andrei, Stoian Mircea, Gliga Florina Ioana, Cocuz Iuliu Gabriel, Sabău Adrian Horațiu, Szabo Dan-Alexandru, Cotoi Ovidiu Simion
Department of Pathophysiology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania.
Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania.
Int J Mol Sci. 2025 Aug 27;26(17):8320. doi: 10.3390/ijms26178320.
Atherosclerosis is now recognized as a chronic inflammatory disease of the arterial wall, in which perivascular adipose tissue (PVAT) has evolved from a passive structural component to a key player in regulating vascular homeostasis and the pathophysiology of atherosclerosis, playing an active, not just structural, role. PVAT surrounds blood vessels and influences them metabolically, immunologically, and vascularly by secreting adipokines, cytokines, and other bioactive mediators. Under physiological conditions, PVAT has protective roles, as it produces adiponectin, nitric oxide (NO), and other vasodilatory factors that help maintain vascular tone and reduce inflammation. In particular, brown-like PVAT (rich in Uncoupling Protein-1 (UCP1) and mitochondria) offers significant vasoprotective effects. Under pathological conditions (obesity, dyslipidemia, insulin resistance), PVAT undergoes a phenotypic transition towards a pro-inflammatory profile by increasing leptin, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) secretion and decreasing adiponectin, contributing to endothelial dysfunction, vascular smooth muscle cell (VSMC) proliferation, local immune cell recruitment, extracellular matrix (ECM) remodeling, and fibrosis. PVAT plays a complex role in vascular health and disease, interacting with systemic metabolism through the secretion of bioactive molecules. Metabolic imbalances can promote PVAT inflammation. Epigenetic alterations and micro ribonucleic acid (miRNAs) can influence PVAT inflammation, and modern imaging methods for PVAT assessment, such as the fat attenuation index (FAI) and artificial intelligence-assisted radiomic profiling, may become predictive biomarkers of cardiac risk. Future directions aim to identify biomarkers and develop targeted therapies that modulate PVAT inflammation and dysfunction in the context of cardiovascular diseases.
动脉粥样硬化现在被认为是一种动脉壁的慢性炎症性疾病，其中血管周围脂肪组织（PVAT）已从一个被动的结构成分演变为调节血管稳态和动脉粥样硬化病理生理学的关键参与者，发挥着积极的作用，而不仅仅是结构上的作用。PVAT围绕血管，并通过分泌脂肪因子、细胞因子和其他生物活性介质在代谢、免疫和血管方面影响血管。在生理条件下，PVAT具有保护作用，因为它产生脂联素、一氧化氮（NO）和其他有助于维持血管张力和减轻炎症的血管舒张因子。特别是，棕色样PVAT（富含解偶联蛋白-1（UCP1）和线粒体）具有显著的血管保护作用。在病理条件下（肥胖、血脂异常、胰岛素抵抗），PVAT通过增加瘦素、肿瘤坏死因子-α（TNF-α）和白细胞介素-6（IL-6）的分泌以及减少脂联素，向促炎表型转变，导致内皮功能障碍、血管平滑肌细胞（VSMC）增殖、局部免疫细胞募集、细胞外基质（ECM）重塑和纤维化。PVAT在血管健康和疾病中发挥着复杂的作用，通过分泌生物活性分子与全身代谢相互作用。代谢失衡可促进PVAT炎症。表观遗传改变和微小核糖核酸（miRNAs）可影响PVAT炎症，而用于PVAT评估的现代成像方法，如脂肪衰减指数（FAI）和人工智能辅助的放射组学分析，可能成为心脏风险的预测生物标志物。未来的方向旨在识别生物标志物并开发靶向治疗方法，以在心血管疾病背景下调节PVAT炎症和功能障碍。
