Adipose Tissue Angiogenesis and Clinical Implications

Adipocytes (ACs) and endothelial cells (ECs) represent two closely interconnected cell lines that determine each other’s functions through a constant and intriguing interplay. The vasculature of adipose tissue (AT) can be considered the orchestrator of internal shifts. The initial signal for this process is believed to originate from both the ACs themselves during dynamic modulation, marked as tissue remodeling (hypertrophy and hyperplasia), and from metabolic signals accompanying these alterations. The analogy of a multifaceted picture of AT can also be extended to the diverse subclasses of ECs, which vary in function and transcriptional profiles. The potential for constant communication between the AT and ECs is based on the fact that every adipocyte in a state of physiological nourishment is supplied by at least one microvascular vessel. The unique vascularization of AT is reflected by the presence of non-permeable blood vessels, namely, continuous capillaries, whose structure is based on a continuous basement membrane and tight junctions between ECs. Angiogenesis is considered a crucial and central component of the processes underlying AT development and its intricate connections with systemic metabolism, exerting influence on progenitor cell proliferation, tissue remodeling, regulation of adipocyte metabolism, and comprehensive adipocyte communication with the rest of the organism. Furthermore, focusing on pathological processes, it is evident that endothelial dysfunction (ED) is a hallmark of obesity. Considering the clinical implications and AT angiogenesis-targeted approach, it is essential to note that specific interactions within this intriguing relationship remain unclear. New findings beyond the simple inhibition of angiogenesis for obesity treatment compound the complexities of therapies in this domain. Therefore, the potential of angiogenesis modulation as a therapeutic tool in obesity treatment has become apparent and prudent. Furthermore, this research could unravel the intriguing and enigmatic communication between AC and ECs, together with the various cellular populations involved in this process.