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Updated: Aug 6, 2026

Precision Ultrasound-guided Stem Cell Delivery for Vascular Repair in Aortic Diseases
Published on: June 20, 2025
The tunica adventitia: From key player in aortic aneurysm pathogenesis to promising therapeutic target
Jia-Heng He1, Mi Wang2, Ting Wang3
1Department of Pharmacology, Xiangya School of Pharmaceutical Sciences, Central South University, Changsha 410013, Hunan, China.
Insights
Aortic aneurysm progression is driven by the adventitia, not just intima and media. Understanding adventitial cell interactions offers new therapeutic targets for this fatal vascular disease.
Area of Science:
- Vascular Biology
- Pathogenesis of Aortic Aneurysm
- Cellular Interactions in Cardiovascular Disease
Background:
- Aortic aneurysm is a fatal vascular disease with limited drug therapies.
- Traditional research focused on intima and media cells.
- Recent evidence highlights the adventitia's critical role in disease progression.
Purpose of the Study:
- To review the multifaceted roles of the aortic adventitia in aneurysm development.
- To explore interactions among adventitial cell types and their microenvironment.
- To identify potential therapeutic strategies targeting the adventitial microenvironment.
Main Methods:
- Literature review of recent studies on aortic aneurysm pathogenesis.
- Focus on cellular and molecular mechanisms within the adventitia.
- Analysis of interactions between adventitial cells, vasa vasorum, and adipose tissue.
Main Results:
- The adventitia, including fibroblasts, immune cells, and progenitor cells, is a key driver of pathological progression.
- Interactions within the adventitial microenvironment fuel chronic inflammation, ECM degradation, and remodeling.
- The vasa vasorum and perivascular adipose tissue significantly influence adventitial responses.
Conclusions:
- The adventitia plays a central role in aortic aneurysm pathogenesis.
- Targeting adventitial cell interactions and the microenvironment presents promising therapeutic avenues.
- Further research into adventitial biology is crucial for developing effective treatments.
Abstract:
Aortic aneurysm is a fatal vascular disease lacking effective drug therapies. Its pathogenesis is complex, with traditional studies mainly focusing on endothelial cells in the intima and smooth muscle cells in the media. Recent studies have shown that aortic adventitia is a key driver of pathological progression, with an increasingly prominent role in the disease process. The core scientific question centers on how diverse adventitial cell populations are activated and how their interactions collectively drive the vicious cycle of chronic inflammation, extracellular matrix degradation, and pathological remodeling. This review summarizes the multifaceted roles of the adventitia in aortic aneurysm development, focusing on interactions among adventitial cell types (fibroblasts, immune cells and progenitor cells), the vasa vasorum, perivascular adipose tissue, and local immune responses, and highlights potential strategies for targeting the adventitial microenvironment.
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