Perivascular Adipose Tissue and Vascular Perturbation/Atherosclerosis

Ha Won Kim, Hong Shi, Michael Alan Winkler, Richard Lee, Neal L. Weintraub

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


Atherosclerosis is orchestrated by complex interactions between vascular and inflammatory cells. Traditionally, it has been considered to be an intimal inflammatory disease, characterized by endothelial dysfunction, inflammatory cell recruitment, lipid oxidation, and foam cell formation. This inside-out signaling paradigm has been accepted as dogma for many years, despite the fact that inflammatory cells are far more prevalent in the adventitia compared with the intima. For decades, the origin of adventitial inflammation in atherosclerosis was unknown. The fact that these inflammatory cells were observed to cluster at the margin of perivascular adipose tissues - a unique and highly inflammatory adipose depot that surrounds most atherosclerosis-prone blood vessels - has stimulated interest in perivascular adipose tissue-mediated outside-in signaling in vascular pathophysiology, including atherosclerosis. The phenotype of perivascular adipocytes underlies the functional characteristics of this depot, including its role in adventitial inflammatory cell recruitment, trafficking to the intima via the vasa vasorum, and atherosclerosis perturbation. This review is focused on emerging concepts pertaining to outside-in signaling in atherosclerosis driven by dysfunctional perivascular adipose tissues during diet-induced obesity and recent strategies for atherosclerosis prediction and prognostication based upon this hypothesis. Graphic Abstract: A graphic abstract is available for this article.

Original languageEnglish (US)
Pages (from-to)2569-2576
Number of pages8
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number11
StatePublished - Nov 1 2020


  • adipokines
  • adipose tissues
  • adventitia
  • atherosclerosis
  • inflammation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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