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February 6, 2026European Heart Journal0 citations

Transformation of perivascular adipose tissue and its influence on vascular cell phenotype: mechanistic insights into AAA progression

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BAB A AlyaviJUJ UzokovAAA X Abdullaev

Key Result

Elevated CCL8 levels in perivascular adipose tissue independently predicted abdominal aortic aneurysm expansion (HR 2.37; 95% CI 1.41-3.98; p=0.002).

Key Points

  • The central aim is to examine how changes in perivascular adipose tissue affect vascular cells in abdominal aortic aneurysm progression.
  • Analyzed PVAT samples from 112 patients (84 AAA, 28 non-AAA) using single-cell RNA sequencing and bulk RNA sequencing.
  • Validated cell distributions through flow cytometry and immunohistochemistry.
  • Conducted functional assays to assess cytokine effects on VSMC phenotype and EC function.
  • Performed differential expression analysis with DESeq2 and pathway enrichment using KEGG and Gene Ontology.
  • Applied statistical tests including Mann-Whitney U test and Cox proportional hazards modeling for aneurysm risk prediction.
  • Identified distinct PVAT cell clusters with pro-inflammatory and fibrotic characteristics.
  • Found increased CCL8 expression in AAA-PVAT, correlating with the dedifferentiation of VSMC and dysfunction of EC.
  • Confirmed elevated CCL8 protein levels in AAA PVAT-conditioned media through ELISA.
  • CCL8 levels were shown to be an independent predictor of AAA expansion in multivariable Cox analysis.

Study Design

Type

Observational (n=112)

Structured PICO

P
Population
112 patients (84 with abdominal aortic aneurysm [AAA], 28 non-AAA controls)
C
Comparator
28 non-AAA controls
O
Outcome
PVAT cell-type-specific transformations and CCL8 expressionsurrogate

Elevated CCL8 levels in perivascular adipose tissue independently predict abdominal aortic aneurysm expansion, highlighting a potential therapeutic target.

Main Result

Effect estimate: HR 2.37 (95% CI 1.41-3.98)

p-value: p=0.002

Abstract

Abstract Background Perivascular adipose tissue (PVAT) undergoes phenotypic changes in abdominal aortic aneurysm (AAA), contributing to vascular remodeling and inflammation. This study investigates the transformation of PVAT and its influence on vascular smooth muscle cells (VSMCs) and endothelial cells (ECs) in AAA progression through transcriptomic profiling and functional analysis. Methods A total of 112 patients (AAA, n = 84; non-AAA controls, n = 28) were included. PVAT samples were analyzed using single-cell RNA sequencing (scRNA-seq) and bulk RNA sequencing to identify cell-type-specific transformations. Flow cytometry and immunohistochemistry validated cell subtype distributions. Functional assays evaluated PVAT-derived cytokine effects on VSMC phenotype switching and EC dysfunction. Differential expression analysis was performed using DESeq2, and pathway enrichment was analyzed via KEGG and Gene Ontology. Statistical comparisons included Mann-Whitney U test, Kruskal-Wallis test, and Cox proportional hazards modeling for aneurysm expansion risk prediction. Results ScRNA-seq identified PVAT cell clusters with distinct transcriptional profiles, including pro-inflammatory macrophages (CD68^+ TNFα^+), fibrotic fibroblasts (COL1A1^+ COL3A1^+), and dysfunctional adipocytes (FABP4ˡow ADIPOQˡow). AAA-PVAT exhibited increased CCL8 expression (log2FC = 2. 48, p = 0. 001), correlating with VSMC dedifferentiation (MYH11ˡow ACTA2ˡow) and EC dysfunction (VCAM1ʰigh SELEʰigh). ELISA confirmed elevated CCL8 protein in PVAT-conditioned media (AAA vs. control: 93. 4 ± 14. 2 pg/mL vs. 41. 7 ± 10. 6 pg/mL, p 0. 001). Multivariable Cox analysis demonstrated CCL8 levels as an independent predictor of AAA expansion (HR 2. 37, 95% CI: 1. 41–3. 98, p = 0. 002). Conclusion PVAT transformation in AAA fosters a pro-inflammatory and fibrotic microenvironment, driving VSMC dedifferentiation and EC dysfunction. CCL8 emerges as a key regulatory target, warranting further investigation for therapeutic intervention.

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Cite This Study

Alyavi et al. (2025) conducted an observational in Abdominal aortic aneurysm (AAA) (n=112). CCL8 levels vs. Non-AAA controls / lower CCL8 levels was evaluated on Aneurysm expansion (HR 2.37, 95% CI 1.41-3.98, p=0.002). Elevated CCL8 levels in perivascular adipose tissue independently predicted abdominal aortic aneurysm expansion (HR 2.37; 95% CI 1.41-3.98; p=0.002).

synapsesocial.com/papers/698585aa8f7c464f23009374https://doi.org/10.1093/eurheartj/ehaf784.3003
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