Table 2. Pharmacological intervention for PVAT inflammation and the challenges of translation.

Interventions	Primary mechanisms	Models	Challenges
Abbreviations: AAA, abdominal aortic aneurysm; AA/AD, aortic aneurysm and dissection; Ang Ⅱ, angiotensin Ⅱ; Apoe, apolipoprotein E; BAPN, β-aminopropionitrile; CALB2, calbindin 2; CCL2, C-C motif chemokine ligand 2; CCR2, C-C motif chemokine receptor 2; HFD, high-fat diet; IL-6, interleukin-6; Mmp12, matrix metalloproteinase 12; NF-κB, nuclear factor kappa-B; PVAT, perivascular adipose tissue; Q-VD-OPh, quinoline-Val-Asp-difluorophenoxymethylketone; SMC, smooth muscle cell; Spp1, secreted phosphoprotein 1; TLR9, Toll-like receptor 9; TNF-α, tumor necrosis factor-α; VEGF-C, vascular endothelial growth factor C.
Genistein	Participate in the regulation of TNF and chemokines	AAA mouse (Ang Ⅱ + Apoe−/−)	The mechanism has not been fully elucidated; there are no mature, specific drugs for the CALB2 target.
Mirabegron	Promote PVAT lymphangiogenesis via adipocyte-derived VEGF-C	AA/AD mouse (Apoe−/− + Ang Ⅱ/BAPN + Ang Ⅱ)	Mirabegron is reported to induce adipocyte browning and may affect body weight in humans.
Metformin	Inhibit Spp1 (encoding osteopontin) and Mmp12 mRNA expression	AAA mouse (Ang Ⅱ + Apoe−/−)	Long-term rupture outcomes were not evaluated; the dose used in non-diabetic human patients is unknown.
Eplerenone	Reduce the expression of TNF-α, IL-6, and MMP-2, as well as macrophage infiltration	AAA mouse (Ang Ⅱ + BAPN)	PVAT-specific delivery was not addressed; systemic mineralocorticoid blockade may cause electrolyte disturbances and off-target effects.
Q-VD-OPh	Inhibit caspase-dependent SMC apoptosis and downregulate CCL2, reducing subsequent macrophage infiltration	AAA mouse (Ang Ⅱ + Apoe−/−)	Systemic caspase inhibition lacks PVAT specificity and may cause off-target effects or toxicity.
Pioglitazone	Reduce mast cells and macrophages and improve vascularization	Clinical trial (insulin-resistant subjects)	The study had a small sample size and limited generalizability; systemic metabolic effects may confound local adipose changes.
Resolvin D2	Downregulate vascular expression of proinflammatory mediators (IL-6, TNF-α, CCL2)	Obese hypertensive mouse (Ang Ⅱ + HFD)	The model is not specific to AAA, limiting direct translational interpretation.
ODN2088	Attenuate NF-κB signaling and restore the anticontractile function of PVAT	Spontaneously hypertensive rat	Translation in AAA remains uncertain; TLR9 modulation may have unintended immune effects.
Propagermanium	Modulate the CCL2/CCR2-monocyte/ macrophage pathway and reduce CD36 expression in PVAT	Non-obese type 2 diabetic Goto-Kakizaki rat	Translation in AAA remains uncertain; PVAT measurements are functional or phenotypic but lack detailed molecular profiling.