Key result
Targeting brown adipose tissue immunometabolic plasticity emerges as a novel strategy for cardiometabolic disease.
Why the study?
Brown adipose tissue has emerged as a pivotal endocrine and immunoregulatory hub influencing cardiovascular immune microenvironment, but its therapeutic potential in cardiovascular diseases requires systematic delineation.
Targeting the endocrine mediator-cardiovascular immune microenvironment axis of brown adipose tissue offers a promising strategy to mitigate systemic inflammation and address cardiometabolic conditions such as atherosclerosis and heart failure.
Brown adipose tissue (BAT) has transcended its classical role as an energy-dissipating thermogenic organ, emerging as a pivotal endocrine and immunoregulatory hub. This review systematically delineates the novel BAT endocrine mediator-cardiovascular immune microenvironment axis. We elucidate how BAT-derived secretomes, encompassing specific batokines, lipid mediators and extracellular vesicles(EVs), orchestrate profound cross-organ crosstalk to modulate systemic cardiovascular immunity. Pathophysiological stress, including obesity and ageing, precipitates BAT whitening and dysregulates local neuro-immune-metabolic reflex arcs, thereby exacerbating atherosclerosis(AS), hypertension and heart failure. Crucially, the phenotypic transformation of perivascular adipose tissue(PVAT) is intimately linked to localized vascular inflammation and macrophage polarization. Furthermore, we critically evaluate cutting-edge pharmacological interventions targeting key pathways, including FGF21 signaling, BAT-derived exosomes, and specific lipid mediators. These therapeutic modalities span conventional adrenergic activators, advanced nanotechnological delivery systems and cell-free epigenetic therapies. By circumventing the cardiovascular toxicities of systemic sympathetic overactivation, these targeted strategies precisely remodel the adipose microenvironment. Ultimately, harnessing the profound immunometabolic plasticity of BAT unveils a groundbreaking therapeutic paradigm for combatting advanced cardiometabolic diseases.
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Liao et al. (2026) conducted a review in cardiometabolic diseases. Brown adipose tissue (BAT) targeted therapies was evaluated. Harnessing the immunometabolic plasticity of brown adipose tissue, including its endocrine and immunoregulatory functions, unveils a groundbreaking therapeutic paradigm for combatting advanced cardiometabolic diseases.
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