The role of periadventitial fat in atherosclerosis.
BACKGROUND
It has become increasingly evident that adipose tissue is a multifunctional organ that produces and secretes multiple paracrine and endocrine factors. Research into obesity, insulin resistance, and diabetes has identified a proinflammatory state associated with obesity. Substantial differences between subcutaneous and omental fat have been noted, including the fact that omental fat produces relatively more inflammatory cytokines. Periadventitial fat, as a specific adipose tissue subset, has been overlooked in the field of atherosclerosis despite its potential diagnostic and therapeutic implications.


OBJECTIVE
To review (1) evidence for the role of adventitial and periadventitial fat in vessel remodeling after injury, (2) the relationship between adventitial inflammation and atherosclerosis, (3) the association between periadventitial fat and plaque inflammation, and (4) the diagnostic and therapeutic implications of these roles and relationships for the progression of atherosclerosis.


METHODS
We present new data showing greater uptake of iron, administered in the form of superparamagnetic iron oxide, in the periadventitial fat of atherosclerotic mice than in control mice. In addition, macrophage density in the periadventitial fat of lipid-rich plaques is increased compared with fibrocalcific plaques.


CONCLUSIONS
There is a striking paucity of data on the relationship between the periadventitial fat of coronary arteries and atherosclerosis. Greater insight into this relationship might be instrumental in making strides into the pathophysiology, diagnosis, and treatment of coronary artery disease.
Vela
Deborah
D
Texas Heart Institute at St Luke's Episcopal Hospital, Houston, USA.
Buja
L Maximilian
LM
Madjid
Mohammad
M
Burke
Alan
A
Naghavi
Morteza
M
Willerson
James T
JT
Casscells
S Ward
SW
Litovsky
Silvio
S
D000273:Adipose Tissue / Q000276:immunology / Q000378:metabolism*; D000818:Animals; D001158:Arteries / Q000378:metabolism*; D050197:Atherosclerosis / Q000209:etiology* / Q000378:metabolism; D003238:Connective Tissue / Q000378:metabolism / Q000473:pathology; D003331:Coronary Vessels / Q000378:metabolism; D005290:Ferric Compounds / Q000493:pharmacokinetics; D006801:Humans; D007249:Inflammation / Q000150:complications*; D007501:Iron / Q000493:pharmacokinetics; D051379:Mice; D012307:Risk Factors
D005290:Ferric Compounds; C000499:ferric oxide; D007501:Iron