Perivascular adipose tissue inflammation in abdominal aortic aneurysm: An underrecognized contributor

Abdominal aortic aneurysm (AAA) is a life-threatening vascular disorder characterized by localized dilation of the abdominal aorta and a high mortality rate once rupture occurs. At present, therapeutic approaches for AAA are primarily confined to operative repair. Thus, a comprehensive understanding of its pathogenesis is crucial for the development of novel pharmacological interventions. Although the underlying mechanisms remain incompletely defined, several critical pathological features have been identified, including inflammation, extracellular matrix degradation, and loss of vascular smooth muscle cells. In recent years, perivascular adipose tissue (PVAT), an active endocrine and paracrine organ surrounding blood vessels, has emerged as an essential regulator of various cardiovascular diseases. PVAT has been shown to remodel the extracellular matrix and influence vascular smooth muscle cell behavior by establishing a pro-inflammatory milieu, thereby affecting the structural integrity and reactivity of the arterial wall. This review summarizes recent research advances in PVAT-driven inflammation in AAA and highlights the translational potential for clinical applications, aiming to provide new insights for future research.