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This review will discuss the paracrine actions of PVAT on the growth of underlying vascular smooth muscle cells (VSMCs). PVAT can release growth factors and inhibitors. Visfatin is the first identified growth factor derived from PVAT. Decreased adiponectin and increased tumour necrosis factor\u2010\u03b1 in PVAT play a pathological role for neointimal hyperplasia after endovascular injury. PVAT\u2010derived angiotensin II, angiotensin 1\u20137, reactive oxygen species, complement component 3, NO and H<jats:sub>2<\/jats:sub>S have a paracrine action on VSMC contraction, endothelial or fibroblast function; however, their paracrine actions on VSMC growth remain to be directly verified. Factors such as monocyte chemoattractant protein\u20101, interleukin\u20106, interleukin\u20108, leptin, resistin, plasminogen activator inhibitor type\u20101, adrenomedullin, free fatty acids, glucocorticoids and sex hormones can be released from adipose tissue and can regulate VSMC growth. Most of them have been verified for their secretion by PVAT; however, their paracrine functions are unknown. Obesity, vascular injury, aging and infection may affect PVAT, causing adipocyte abnormality and inflammatory cell infiltration, inducing imbalance of PVAT\u2010derived growth factors and inhibitors, leading to VSMC growth and finally resulting in development of proliferative vascular disease, including atherosclerosis, restenosis and hypertension. In the future, using cell\u2010specific gene interventions and local treatments may provide definitive evidence for identification of key factor(s) involved in PVAT dysfunction\u2010induced vascular disease and thus may help to develop new therapies.<\/jats:p><jats:p><jats:bold>LINKED ARTICLES<\/jats:bold>This article is part of a themed section on Fat and Vascular Responsiveness. To view the other articles in this section visit<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/dx.doi.org\/10.1111\/bph.2012.165.issue-3\">http:\/\/dx.doi.org\/10.1111\/bph.2012.165.issue\u20103<\/jats:ext-link><\/jats:p>","DOI":"10.1111\/j.1476-5381.2011.01404.x","type":"journal-article","created":{"date-parts":[[2011,4,6]],"date-time":"2011-04-06T16:02:03Z","timestamp":1302105723000},"page":"643-658","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":153,"title":["The role of perivascular adipose tissue in vascular smooth muscle cell 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