Perivascular Adipose Tissue – Orchestrator of Cardiovascular Disturbances Sequel.

Perivascular adipose tissue is a biologically active morphofunctional unit that is an active regulator of endovascular homeostasis, endothelial functioning, and the phenotypic state of smooth muscle. Under physiological conditions, perivascular adipose tissue maintains normal vascular function by releasing anti-atherogenic, anti-inflammatory, and vasodilating biologically active substances. Until recently, adipose tissue was considered a morphological unit with only a thermoregulatory and shock-absorbing function; however, with the development and improvement of modern medical science, we can confidently assert that adipose tissue is a factory for the production of biologically active substances with a broad spectrum of action. The released biologically active substances have both autocrine and paracrine effects, thus playing a pivotal role in maintaining the morphophysiological balance of the whole organism. Various theories are put forward about the possible key role of perivascular adipose tissue in the pathogenesis of various diseases. It has been shown that perivascular tissue is an independent cardiovascular risk factor, even without visceral obesity. When exposed to specific pathogens, the regulation of adipocytes is disrupted, and a subsequent rearrangement of the adipocyte production profile occurs. The secretion of damaged adipocytes exhibits the following properties: anti-atherogenic, anti-inflammatory, and vasodilating, with subsequent initiation or progression of cardiovascular disease. Within the framework of this review article, the following are raised and comprehensively discussed: the function of perivascular adipose tissue in health and disease and its contribution to the pathogenesis of cardiovascular disease. This review aims to analyze the data of modern literature, reflecting the photomorphogenesis of changes in the secretory activity of perivascular adipose tissue, along with the molecular mechanisms of cardiovascular system alteration.