Role of adipose tissue in the perivascular space in aortic wall matrix inflammation and degeneration in thoracoabominal aortic aneurysms

Background: Thoracoabdominal aortic aneurysms (TAAAs) are usually asymptomatic, associated with high mortality due to rupture and often occur in patients with a significant comorbidity profile. Despite established screening methods, specific diagnostic and prognostic biomarkers and appropriate drug treatment for vascular pathologies are lacking. Adaptive perivascular adipose tissue (PVAT) is increasingly being recognized as a critical factor in vascular pathology and a potential therapeutic target due to its multiple functions. Research question: What is the functional role of PVAT in aortic wall inflammation and extracellular matrix degeneration in TAAA? Results: As a central secretory organ PVAT modulates vascular homeostasis and due to the close anatomical relationship also local tissue inflammation. In addition to local inflammatory processes, a dysfunctional PVAT promotes matrix degeneration and also the development and progression of aortic aneurysms. Conclusion: Due to its influence on vascular biology and its complex endocrine functions, the perivascular adipocyte stroma represents a clinically relevant and promising source of diagnostic and prognostic biomarkers.