The artery wall consists ofintima, media, and adventitia, the latter gradually transiting into the periadventitial adipose tissue (PAAT). Although many paths lead to atherosclerosis, the prevailing paradigm at present is Russell Ross's response-to-injury hypothesis, which states that atherosclerosis is a chronic inflammatory disease. This hypothesis considers the intimal smooth muscle cell proliferation as a key event in the generation, development and complication of atherosclerosis. Thus the potentially important role played by adventitial fibroblasts/myofibroblasts in atherosclerosis and postangioplasty restenosis, suggesting therapeutic perspectives targeted to these particular cells, has been neglected. Here we go further away from the intima, and focus on the potential involvement of PAAT in the process of atherogenesis and angioplasty-induced restenosis.
Biomedical Reviews 2002; 13: 63-65.