Perivascular adipose tissue (PVAT) helps regulate arterial homeostasis and plays a role in the pathogenesis of large vessel diseases. In this study, we investigated whether the PVAT of aortic occlusive lesions shows specific gene-expression patterns related to pathophysiology. By a genomewide approach, we investigated the PVAT transcriptome in patients with aortoiliac occlusive disease. We compared the adipose layer surrounding the distal aorta (atherosclerotic lesion) with the proximal aorta (plaque-free segment), both within and between patients with complete aortoiliac occlusion (Oc) and low-grade aortic stenosis (St). We found that PVAT of the distal versus proximal aorta within both Oc-and St-patients lacks specific, locally restricted gene-expression patterns. Conversely, singular gene-expression profiles distinguished the PVAT between Oc-and St-patients. Functional enrichment analysis revealed that these signatures were associated with pathways related to metabolism of cholesterol, vessel tone regulation, and remodeling, including TGF-β and SMAD signaling. We finally observed that gene-expression profiles in omental-visceral or subcutaneous fat differentiated between Oc-and St-patients, suggesting that the overall adipose component associates with a different atherosclerosis burden. Our work points out the role of PVAT and, likely, other adipose tissues play in the pathophysiological mechanisms underlying atherosclerotic disease, including the abdominal aortic occlusive forms.Common pathologies of the distal abdominal aorta include the dilated (aneurysmal) and the obstructive (atherosclerotic) forms 1,2 . Although the two conditions share some vascular risk factors (eg, cigarette smoking, hypertension, dyslipidemia), both epidemiology 3,4 and pathogenesis 5-7 of the diseases are clearly different. Even so, increasing evidences suggest that dysfunctional perivascular adipose tissue (PVAT) participates in the development and progression of both atherosclerotic and nonatherosclerotic vascular diseases 8,9 , including those affecting the distal abdominal aorta.PVAT is known to influence artery homeostasis by tuning many physiological functions, which comprise the regulation of vessel tone through the activation of pro-or anti-contractile mechanisms, secretion of soluble factors, and modulation of local inflammation 10 , and its dysfunction may adversely affect vessel health. PVAT is highly heterogeneous and its pathophysiological roles may be different depending on the segments of the artery beds 11 . Gene expression dataset. Following the probe-filtering criteria, we identified 18149 expressed probes.After re-annotation, we obtained a final expression matrix of 14352 transcripts, which correspond to 11105 unique genes (annotation details in the online-only Data Supplement 2).
Adipose tissue samples clustering by principal component analysis (PCA) on whole gene-expression data.We used the entire, adjusted gene-expression matrix of PVAT, subcutaneous and omental-visceral adipose tissue (AT) samples of the PAD p...