Atherosclerotic lesions: Possible interactive involvement of intima, adventitia and associated adipose tissue

Objective: In atherosclerosis research numerous studies have traditionally pursued the intimal pathology, while the involvement of adventitia has recently received an increasing whereas artery-associated adipose tissue (AAAT), thus far, a little attention. The present review focuses on a possible interactive, paracrine/autocrine involvement of intima, adventitia and AAAT in the pathobiology of atherogenesis. Design: Questions as to whether signals and/or cells from both the adventitia and the AAAT may propagate (signals) and/or migrate (cell) into the intima, to be involved in atherosclerotic plaque formation, are discussed. Also, a more precise examination of subepicardial adipose tissue in studying coronary atherosclerosis is emphasized. Conclusion: Believing that the atherogenesis is not just for intima, a comprehensive evaluation of both adventitia-derived signals (and/or cells) and AAAT-derived adipokines (adipose tissue-secreted molecules) becomes mandatory, since their identification may yield clues to a possible transmission of proatherogenic and/or antiatherogenic stimuli, from adventitia and AAAT toward the vascular intima.