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Bidirectional paradigm. Signals from the lumen and from the endothelial/luminal surface modulate PVAT function/dysfunction by the inside‐outside paradigm described by Russel Ross. Alterations in PVAT then have a paracrine beneficial/deleterious influence on the endothelium. 4‐HNE, 4‐hydroxynonenal; BH4, tetrahydrobiopterin; MCP‐1, monocyte chemoattractant protein; NOX, NADPH oxidase; O2 −, superoxide anion; PAI‐1, plasminogen activator inhibitor type 1.
