BACKGROUND:Tranexamic acid (TXA) is widely used in plastic surgery to reduce perioperative blood loss, hematoma formation, and postoperative ecchymosis. Its incorporation into tumescent solution for liposuction and fat grafting has increased; however, the effects of TXA on adipose tissue biology and progenitor cell function remain incompletely understood. METHODS:Human subcutaneous adipose tissue explants were cultured in a 3-dimensional system with vehicle control (0), 5, 10, 100, and 1000μg/mL TXA. Capillary sprouting was assessed from days 4 to 11. After 14 days, human adipose capillary-associated progenitor cells (HACAPs) were isolated from explants and expanded in 2-dimensional culture under identical TXA conditions. An independent HACAP line derived from panniculectomy tissue was evaluated in parallel. Cell proliferation was assessed over 2 to 3 expansion cycles. Adipogenic differentiation was induced using standard differentiation media and evaluated by lipid accumulation and RT-qPCR for adipogenic markers (AdipoQ, PLIN1, FABP4). Thermogenic responsiveness was assessed after forskolin stimulation by measuring expression of UCP1, LINC473, and DIO2. RESULTS:Increasing TXA concentrations were associated with a transient attenuation of early capillary sprouting at early time points (≤4d); this effect resolved by day 5, with no sustained differences in sprouting thereafter. HACAP yield, proliferation rates, and cellular morphology were comparable across all treatment groups. Adipogenic differentiation, as assessed by lipid droplet formation and expression of adipogenic genes, did not differ between TXA-treated and control cells. After thermogenic stimulation, expression of thermogenic markers was similarly unchanged across all conditions. CONCLUSIONS:Clinically relevant concentrations of TXA do not impair adipose progenitor cell viability, proliferation, adipogenic differentiation, or thermogenic responsiveness in vitro. These findings support the cellular safety of TXA use in liposuction and fat grafting and provide reassurance as adoption of TXA continues to expand in plastic and reconstructive surgery.

The ability to generate, store, and mobilize energy is fundamental to life, and disruptions in these processes underlie metabolic disease. This review examines how these mechanisms evolved to rely profoundly on lipids, a large family of molecules that serve an unusually wide range of biological functions. From early evolutionary times, lipids have enabled chemiosmotic energy transduction, organized the endomembrane systems that synthesize and package neutral lipids, served as concentrated reservoirs of metabolic energy, and functioned as signaling molecules that coordinate cellular and systemic physiology. Adipocytes are specialized cells that can accumulate large amounts of lipid within specialized lipid droplet organelles. Over evolutionary time, mammals developed distinct adipocyte subtypes with tailored physiological roles. White adipocytes, characterized by a single large unilocular lipid droplet, coordinate energy storage and release in response to systemic cues. In contrast, the role of brown and beige adipocytes is to protect the organism from cold exposure by generating heat as a primary output of UCP1-mediated mitochondrial uncoupling. Crucially, this thermogenic process requires extensive systemic coordination: sympathetic neural input triggers lipolysis, vascular networks deliver fuel from multiple adipose depots, and hormonal signals integrate metabolic demand across organs. These requirements position thermogenic adipocytes as metabolic integration “nodes” that orchestrate whole-body fuel allocation and energy homeostasis. The presence of functional thermogenic adipocytes is strongly associated with improved cardiometabolic health, protecting against obesity, type 2 diabetes, and cardiovascular disease. Understanding how these specialized cells sense and respond to systemic signals offers a powerful entry point for developing strategies to counteract metabolic disease.

Adipose tissue has emerged as a central regulator of human physiology, with its dysfunction driving the global rise in obesity-associated diseases, such as type 2 diabetes, cardiovascular and liver diseases, and several cancers. Once thought to be inert, adipocytes are now recognized as dynamic, responsive cells essential for energy homeostasis and interorgan communication, including the brain. Distinct adipose depots support specialized functions across development, sex, and aging. Technologies like single-cell RNA sequencing are unraveling depot-specific mechanisms, with the potential of identifying new therapeutic targets. This review highlights major scientific advancements leading to our current appreciation of the pivotal role of adipose tissue in health and disease. Many key discoveries in this field have been catalyzed by National Institutes of Health funding, particularly through the National Institute of Diabetes, Digestive and Kidney Diseases, now celebrating its 75th anniversary.

The ability to generate, store, and mobilize energy is fundamental to life, and disruptions in these processes underlie metabolic disease. This review examines how these mechanisms evolved to rely profoundly on lipids, a large family of molecules that serve an unusually wide range of biological functions. From early evolutionary times, lipids have enabled chemiosmotic energy transduction, organized the endomembrane systems that synthesize and package neutral lipids, served as concentrated reservoirs of metabolic energy, and functioned as signaling molecules that coordinate cellular and systemic physiology. Adipocytes are specialized cells that can accumulate large amounts of lipid within specialized lipid droplet organelles. Over evolutionary time, mammals developed distinct adipocyte subtypes with tailored physiological roles. White adipocytes, characterized by a single large unilocular lipid droplet, coordinate energy storage and release in response to systemic cues. In contrast, the role of brown and beige adipocytes is to protect the organism from cold exposure by generating heat as a primary output of UCP1-mediated mitochondrial uncoupling. Crucially, this thermogenic process requires extensive systemic coordination: sympathetic neural input triggers lipolysis, vascular networks deliver fuel from multiple adipose depots, and hormonal signals integrate metabolic demand across organs. These requirements position thermogenic adipocytes as metabolic integration "nodes" that orchestrate whole-body fuel allocation and energy homeostasis. The presence of functional thermogenic adipocytes is strongly associated with improved cardiometabolic health, protecting against obesity, type 2 diabetes, and cardiovascular disease. Understanding how these specialized cells sense and respond to systemic signals offers a powerful entry point for developing strategies to counteract metabolic disease.

ABSTRACT Background Adipose tissue surrounding the heart and vasculature plays critical roles in cardiovascular homeostasis and disease, yet the cellular and molecular milieu of these depots at single-cell resolution remains incompletely characterized. Understanding how regional adipocytes differ transcriptionally and communicate with neighboring cardiovascular cells is essential for developing targeted therapeutic strategies. Methods We performed single-nucleus RNA sequencing (snRNA-seq) on human adipose tissue from four anatomically distinct depots: ascending aorta, left atrium, right coronary artery, and subcutaneous fat. We characterized cellular composition, adipocyte and progenitor heterogeneity, depot-specific transcriptional programs, and intercellular communication networks. We further examined signaling remodeling in disease contexts, including atrial fibrillation and aortic aneurysm. Results We identified six transcriptionally distinct adipocyte subpopulations and six adipocyte stromal and progenitor cell (ASPC) subpopulations were shared across depots but showed marked differences in abundance and gene expression reflecting developmental imprinting, including HOX family genes and anterior–posterior patterning programs. Intercellular communication analysis revealed depot-specific ligand-receptor interactions, with EPHA signaling identified as selectively enriched in the left atrial adipose depot. Disease-state analyses demonstrated extensive change in cell-cell communication in atrial fibrillation and aortic aneurysm, with differential regulation of FN1, EGF, SLIT, NOTCH, and CD46 signaling pathways. Conclusions Our study reveals that cardiac and vascular adipose depots harbor transcriptionally specialized adipocytes and progenitors with distinct intercellular communication programs that are remodeled in atrial fibrillation and aortic aneurysm.

Adipose tissue (AT) is a complex connective tissue with a high relative proportion of adipocytes, which are specialized cells with the ability to store lipids in large droplets. AT is found in multiple discrete depots throughout the body, where it serves as the primary repository for excess calories. In addition, AT has an important role in functions as diverse as insulation, immunity and regulation of metabolic homeostasis. The Human Cell Atlas Adipose Bionetwork was established to support the generation of single-cell atlases of human AT as well as the development of unified approaches and consensus for cell annotation. Here, we provide a first roadmap from this bionetwork, including our suggested cell annotations for humans and mice, with the aim of describing the state of the field and providing guidelines for the production, analysis, interpretation and presentation of AT single-cell data. In this Review, the authors present a roadmap towards achieving consensus on development, analysis and interpretation of single-cell transcriptomics data in adipose tissue, including discussion of roadblocks, best practices and ideal cell-type markers for annotation of adipose tissue cell types in mice and humans.

Congenital generalized lipodystrophy type 2 (CGL2) is caused by mutations in the BSCL2 gene, which encodes the protein seipin. However, how seipin loss causes adipose tissue failure remains unclear. Using human adipocyte progenitor cells capable of robust differentiation in vitro and in vivo, we reveal two unexpected findings that redefine CGL2 pathogenesis. First, seipin is dispensable for lipid droplet biogenesis but essential for recruiting the major adipocyte scaffold protein Perilipin 1 (PLIN1) to the lipid droplet surface. Second, we discover that the integrity of the lipid droplet serves as an organelle to nucleus quality control checkpoint enforcing adipocyte identity. Without seipin-dependent PLIN1 recruitment, adipocytes exhibit enhanced lipolysis and ceramide accumulation, triggering an unexpected cellular response of de-differentiation into a progenitor-like state. From this de-differentiated state, cells can undergo additional cycles of differentiation and de-differentiation upon repeated adipogenic stimuli. However, some cells escape de-differentiation, instead forming a single large droplet and displaying severe cellular structural abnormalities. Consistent with this model, we find functional adipose tissue can form in vivo from seipin-deficient cells, yet ultimately fails. These findings resolve conflicting models of CGL2 pathogenesis by reframing seipin as a regulator of PLIN1 recruitment, rather than droplet formation per se, and reveal the fundamental role of lipid droplet integrity in the development of functional human adipocytes.

During peripheral vascular disease and aging, adipose tissue within the bone marrow expands while the trabecular red marrow contracts. The impact of these changes on blood cell formation remains unclear. To address this question, we performed single-cell and single-nuclei transcriptomic analysis on adipose-rich yellow bone marrow (BMY) and adipose-poor trabecular red marrow (BMR) from human subjects undergoing lower limb amputations. Surprisingly, we discovered two distinct hematopoietic niches, in which BMY contains a higher number of monocytes and progenitor cells expressing pro-inflammatory gene signatures. To further investigate these niches, we developed an in-vitro organoid system that recapitulates key features of the human bone marrow. Progenitor cells from BMY exhibited enriched expression of the leptin receptor, and responded to leptin with increased proliferation and monocyte production. These findings suggest that the age-associated expansion of bone marrow adipose tissue promotes a pro-inflammatory state by stimulating monocyte production from a spatially distinct, leptin-responsive hematopoietic stem/progenitor cell population.

Aging and metabolic diseases are accompanied by systemic inflammation, but the mechanisms that induce this state are not known. We developed a human bone-marrow organoid system to explore mechanisms underlying metabolic-disease associated systemic inflammation. We find that a distinct type of hematopoietic stem cell (HSC) develops in the adipose-rich, yellow bone marrow, which is known to gradually replace the hematopoietic red marrow as we age and during metabolic disease. Unlike HSCs derived from the red bone marrow, HSCs derived from the yellow bone marrow have higher proliferation rates, increase myeloid differentiation, skew towards pro-inflammatory M1 macrophage differentiation, and express a distinct transcriptomic profile associated with responsiveness to wounding. Yellow marrow-derived HSCs express higher levels of the leptin receptor, which we find to be further increased in patients with type 2 diabetes. Our work demonstrates that the human long bone yellow marrow is a niche for a distinct class of HSCs which could underlie hematopoietic dysfunction during aging and metabolic disease processes suggesting a shared inflammaging mechanism.

Adipose tissue remodeling and dysfunction, characterized by elevated inflammation and insulin resistance, play a central role in obesity -related development of type 2 diabetes (T2D) and cardiovascular diseases. Long intergenic non -coding RNAs (lincRNAs) are important regulators of cellular functions. Here, we describe the functions of linc-ADAIN (adipose anti-inflammatory), an adipose lincRNA that is downregulated in white adipose tissue of obese humans. We demonstrate that linc-ADAIN knockdown (KD) increases KLF5 and interleukin-8 (IL -8) mRNA stability and translation by interacting with IGF2BP2. Upregulation of KLF5 and IL -8, via linc-ADAIN KD, leads to an enhanced adipogenic program and adipose tissue inflammation, mirroring the obese state, in vitro and in vivo . KD of linc-ADAIN in human adipose stromal cell (ASC) hTERT adipocytes implanted into mice increases adipocyte size and macrophage infiltration compared to implanted control adipocytes, mimicking hallmark features of obesity -induced adipose tissue remodeling. linc-ADAIN is an anti-inflammatory lincRNA that limits adipose tissue expansion and lipid storage.

Ageing is a conserved biological process, modulated by intrinsic and extrinsic factors, that leads to changes in life expectancy. In humans, ageing is characterized by greatly increased prevalence of cardiometabolic disease, type 2 diabetes and disorders associated with impaired immune surveillance. Adipose tissue displays species-conserved, temporal changes with ageing, including redistribution from peripheral to central depots, loss of thermogenic capacity and expansion within the bone marrow. Adipose tissue is localized to discrete depots, and also diffusely distributed within multiple organs and tissues in direct proximity to specialized cells. Thus, through their potent endocrine properties, adipocytes are capable of modulating tissue and organ function throughout the body. In addition to adipocytes, multipotent progenitor/stem cells in adipose tissue play a crucial role in maintenance and repair of tissues throughout the lifetime. Adipose tissue may therefore be a central driver for organismal ageing and age-associated diseases. Here we review the features of adipose tissue during ageing, and discuss potential mechanisms by which these changes affect whole-body metabolism, immunity and longevity. We also explore the potential of adipose tissue-targeted therapies to ameliorate age-associated disease burdens. Nguyen and Corvera review distinct changes that occur in adipose tissue during ageing, discuss potential mechanisms by which these changes impact whole-body metabolism, immunity and longevity, and highlight therapeutic opportunities.

OBJECTIVE:The uncoupling protein 1 (UCP1) is induced in brown or "beige" adipocytes through catecholamine-induced cAMP signaling, which activates diverse transcription factors. UCP1 expression can also be enhanced by PPARγ agonists such as rosiglitazone (Rsg). However, it is unclear whether this upregulation results from de-novo differentiation of beige adipocytes from progenitor cells, or from the induction of UCP1 in pre-existing adipocytes. To explore this, we employed human adipocytes differentiated from progenitor cells and examined their acute response to Rsg, to the adenylate-cyclase activator forskolin (Fsk), or to both simultaneously. METHODS:Adipocytes generated from primary human progenitor cells were differentiated without exposure to PPARγ agonists, and treated for 3, 6 or 78 h to Fsk, to Rsg, or to both simultaneously. Bulk RNASeq, RNAScope, RT-PCR, CRISPR-Cas9 mediated knockout, oxygen consumption and western blotting were used to assess cellular responses. RESULTS:UCP1 mRNA expression was induced within 3 h of exposure to either Rsg or Fsk, indicating that Rsg's effect is independent on additional adipocyte differentiation. Although Rsg and Fsk induced distinct overall transcriptional responses, both induced genes associated with calcium metabolism, lipid droplet assembly, and mitochondrial remodeling, denoting core features of human adipocyte beiging. Unexpectedly, we found that Fsk-induced UCP1 expression was reduced by approximately 80% following CRISPR-Cas9-mediated knockout of PNPLA2, the gene encoding the triglyceride lipase ATGL. As anticipated, ATGL knockout suppressed lipolysis; however, the associated suppression of UCP1 induction indicates that maximal cAMP-mediated UCP1 induction requires products of ATGL-catalyzed lipolysis. Supporting this, we observed that the reduction in Fsk-stimulated UCP1 induction caused by ATGL knockout was reversed by Rsg, implying that the role of lipolysis in this process is to generate natural PPARγ agonists. CONCLUSIONS:UCP1 transcription is known to be stimulated by transcription factors activated downstream of cAMP-dependent protein kinases. Here we demonstrate that UCP1 transcription can also be acutely induced through PPARγ-activation. Moreover, both pathways are activated in human adipocytes in response to cAMP, synergistically inducing UCP1 expression. The stimulation of PPARγ in response to cAMP may result from the production of natural PPARγ activating ligands through ATGL-mediated lipolysis.

Objective:The uncoupling protein 1 (UCP1) is induced in brown or "beige" adipocytes through catecholamine-induced cAMP signaling, which activates diverse transcription factors. UCP1 expression can also be enhanced by PPARγ agonists such as rosiglitazone (Rsg). However, it is unclear whether this upregulation results from de-novo differentiation of beige adipocytes from progenitor cells, or from the induction of UCP1 in pre-existing adipocytes. To explore this, we employed human adipocytes differentiated from progenitor cells and examined their acute response to Rsg, to the adenylate-cyclase activator forskolin (Fsk), or to both simultaneously. Methods:Adipocytes generated from primary human progenitor cells were differentiated without exposure to PPARγ agonists, and treated for 3, 6 or 78 hours to Fsk, to Rsg, or to both simultaneously. Bulk RNASeq, RNAScope, RT-PCR, CRISPR-Cas9 mediated knockout, oxygen consumption and western blotting were used to assess cellular responses. Results:UCP1 mRNA expression was induced within 3 hours of exposure to either Rsg or Fsk, indicating that Rsg's effect is independent on additional adipocyte differentiation. Although Rsg and Fsk induced distinct overall transcriptional responses, both induced genes associated with calcium metabolism, lipid droplet assembly, and mitochondrial remodeling, denoting core features of human adipocyte beiging. Unexpectedly, we found that Fsk-induced UCP1 expression was reduced by approximately 80% following CRISPR-Cas9-mediated knockout of PNPLA2 , the gene encoding the triglyceride lipase ATGL. As anticipated, ATGL knockout suppressed lipolysis; however, the associated suppression of UCP1 induction indicates that maximal cAMP-mediated UCP1 induction requires products of ATGL-catalyzed lipolysis. Supporting this, we observed that the reduction in Fsk-stimulated UCP1 induction caused by ATGL knockout was reversed by Rsg, implying that the role of lipolysis in this process is to generate natural PPARγ agonists. Conclusion:UCP1 transcription is known to be stimulated by transcription factors activated downstream of cAMP-dependent protein kinases. Here we demonstrate that UCP1 transcription can also be acutely induced through PPARγ-activation. Moreover, both pathways are activated in human adipocytes in response to cAMP, synergistically inducing UCP1 expression. The stimulation of PPARγ in response to cAMP occurs as a result of the production of natural PPARγ activating ligands through ATGL-mediated lipolysis. GRAPHICAL ABSTRACT:

Subcutaneous adipose tissue protects from T2D by sequestering lipids and preventing lipotoxicity and insulin resistance. Adipose depots are maintained throughout the lifetime by the formation of new adipocytes from mesenchymal progenitor cells that reside within the tissue. In previous studies, we have found that mesenchymal progenitor cells from human adipose tissue can be expanded with little loss of multipotency by culturing tissue explants in 3-dimensional hydrogels under pro-angiogenic conditions. Mesenchymal progenitor cells obtained in this manner can be induced to differentiate into multiple adipocyte subtypes, including beige adipocytes characterized by their induction of UCP1 upon cAMP elevation. Using this approach, we explored whether mesenchymal progenitor cells from the subcutaneous abdominal (ABD) and gluteal (GLU) depots of subjects with normal glucose tolerance (NGT) or T2D would differ in their capacity to differentiate into adipocyte subtypes. Results from n=12 subjects (6 with NGT and 6 with T2D) revealed no significant differences between depots or glycemic states in the number of mesenchymal progenitor cells that can be expanded, in their proliferative rate upon subsequent passaging, or in their capacity to differentiate into either white or beige adipocytes. However, we found that cells from either the ABD or GLUT depot from NGT subjects displayed substantial spontaneous adipocyte differentiation even without adipogenic induction, but cells from subjects with T2D did not. This difference was highly significant, and potentially reflects a diminished capacity of mesenchymal progenitor cells to maintain subcutaneous adipose depots in-vivo in subjects with T2D. Further transcriptomic and epigenomic analyses of expanded progenitor cells, currently underway, has the potential to reveal cellular mechanisms of impaired spontaneous adipocyte differentiation in subjects with Type 2 Diabetes. Disclosure S.Corvera: None. T.A.Desouza: None. R.N.Ziegler: None. N.Rosano: None. M.J.Thompson: None.

Objectives: There is limited understanding on how diabetes negatively impacts wound healing after ischemic tissue damage. Murine models for limb ischemia and myocardial infarction have demonstrated that recruitment of bone marrow hematopoietic stem cell (HSC)-derived immune cells at all stages of ischemic tissue remodeling and healing. By leveraging our lab’s three-dimensional (3D) bone marrow organoid culture system used to study human HSC, we aim to study the effect of diabetes on immune cell development. Methods: Surgically discarded bone marrow tissue samples from patients undergoing lower extremity amputation for non-healing ulcer or tissue loss was used to develop our bone marrow 3D organoid culture system. Human HSCs are identified using fluorescence-tagged antibodies against cell surface markers. Hematopoietic potential of bone marrow-derived HSCs was tested using colony forming unit assay. In vitro immune cell differentiation into monocyte and macrophage was performed. Bulk RNA libraries were sequenced on the NextSeq 500 system (Illumina) and analysis done on DeBrowser. Results: Our novel human bone marrow co-culture system provides a method for bone marrow cell expansion from primary human bone marrow tissue explants. De novo sprouting cells can be observed growing from bone marrow tissue explants harvested from non-diabetic and diabetic donors. Using fluorescence-activated cell sorting analysis, we identified a trend towards reduced HSC numbers in diabetic when compared to non-diabetic donors. HSC derived from both diabetic and non-diabetic bone marrow tissue explants were able to undergo hematopoiesis and immune cell differentiation. Bulk RNA sequencing demonstrates distinct gene expression profiles of the cells expanded from non-diabetic and diabetic bone marrow cells. Conclusions: Our 3D bone marrow organoid culture system will allow for future comparative studies between the non-diabetic and diabetic immune system. The preliminary data suggest that there are gene expression profile differences between bone marrow progenitor cells from diabetic and non-diabetic donors. These gene expression differences may attribute to alterations in the HSC number and immune cell development observed in diabetes.

Adipocyte lipid droplets (LDs) play a crucial role in systemic lipid metabolism by storing and releasing lipids to meet the organism's energy needs. Hormonal signals such as catecholamines and insulin act on adipocyte LDs, and impaired responsiveness to these signals can lead to uncontrolled lipolysis, lipotoxicity, and metabolic disease. To investigate the mechanisms that control LD function in human adipocytes, we applied proximity labeling mediated by enhanced ascorbate peroxidase (APEX2) to identify the interactome of PLIN1 in adipocytes differentiated from human mesenchymal progenitor cells. We identified 70 proteins that interact specifically with PLIN1, including PNPLA2 and LIPE, which are the primary effectors of regulated triglyceride hydrolysis, and 4 members of the 14-3-3 protein family (YWHAB, YWHAE, YWHAZ, and YWHAG), which are known to regulate diverse signaling pathways. Functional studies showed that YWHAB is required for maximum cyclic adenosine monophosphate (cAMP)-stimulated lipolysis, as its CRISPR-Cas9-mediated knockout mitigates lipolysis through a mechanism independent of insulin signaling. These findings reveal a new regulatory mechanism operating in human adipocytes that can impact lipolysis and potentially systemic metabolism.

Mesenchymal stem/progenitor cells are essential for tissue development and repair throughout life, but how they are maintained under chronic differentiation pressure is not known. Using single-cell transcriptomics of human progenitor cells we find that adipose differentiation stimuli elicit two cellular trajectories: one toward mature adipocytes and another toward a pool of non-differentiated cells that maintain progenitor characteristics. These cells are induced by transient Wnt pathway activation and express numerous extracellular matrix genes and are therefore named structural Wnt-regulated adipose tissue cells. We find that the genetic signature of structural Wnt-regulated adipose tissue cells is present in adult human adipose tissue and adipose tissue developed from human progenitor cells in mice. Our results suggest a mechanism whereby adipose differentiation occurs concurrently with the maintenance of a mesenchymal progenitor cell pool, ensuring tissue development, repair and appropriate metabolic control over the lifetime.

Adipose tissue distribution in the human body is highly heterogeneous, and the relative mass of different depots is differentially associated with metabolic disease risk. Distinct functions of adipose depots are mediated by their content of specialized adipocyte subtypes, best exemplified by thermogenic adipocytes found in specific depots. Single-cell transcriptome profiling has been used to define the cellular composition of many tissues and organs, but the large size, buoyancy, and fragility of adipocytes have rendered it challenging to apply these techniques to understand the full complexity of adipocyte subtypes in different depots. Discussed here are strategies that have been recently developed for investigating adipocyte heterogeneity, including single-cell RNA-sequencing profiling of the stromal vascular fraction to identify diverse adipocyte progenitors, and single-nuclei profiling to characterize mature adipocytes. These efforts are yielding a more complete characterization of adipocyte subtypes in different depots, insights into the mechanisms of their development, and perturbations associated with different physiological states such as obesity. A better understanding of the adipocyte subtypes that compose different depots will help explain metabolic disease phenotypes associated with adipose tissue distribution and suggest new strategies for improving metabolic health.

Mechanisms that control 'beige/brite' thermogenic adipose tissue development may be harnessed to improve human metabolic health. To define these mechanisms, we developed a species-hybrid model in which human mesenchymal progenitor cells were used to develop white or thermogenic/beige adipose tissue in mice. The hybrid adipose tissue developed distinctive features of human adipose tissue, such as larger adipocyte size, despite its neurovascular architecture being entirely of murine origin. Thermogenic adipose tissue recruited a denser, qualitatively distinct vascular network, differing in genes mapping to circadian rhythm pathways, and denser sympathetic innervation. The enhanced thermogenic neurovascular network was associated with human adipocyte expression of THBS4, TNC, NTRK3, and SPARCL1, which enhance neurogenesis, and decreased expression of MAOA and ACHE, which control neurotransmitter tone. Systemic inhibition of MAOA, which is present in human but absent in mouse adipocytes, induced browning of human but not mouse adipose tissue, revealing the physiological relevance of this pathway. Our results reveal species-specific cell type dependencies controlling the development of thermogenic adipose tissue and point to human adipocyte MAOA as a potential target for metabolic disease therapy.

While most tissues exhibit their greatest growth during development, adipose tissue is capable of additional massive expansion in adults. Adipose tissue expandability is advantageous when temporarily storing fuel for use during fasting, but becomes pathological upon continuous food intake, leading to obesity and its many comorbidities. The dense vasculature of adipose tissue provides necessary oxygen and nutrients, and supports delivery of fuel to and from adipocytes under fed or fasting conditions. Moreover, the vasculature of adipose tissue comprises a major niche for multipotent progenitor cells, which give rise to new adipocytes and are necessary for tissue repair. Given the multiple, pivotal roles of the adipose tissue vasculature, impairments in angiogenic capacity may underlie obesity-associated diseases such as diabetes and cardiometabolic disease. Exciting new studies on the single-cell and single-nuclei composition of adipose tissues in mouse and humans are providing new insights into mechanisms of adipose tissue angiogenesis. Moreover, new modes of intercellular communication involving micro vesicle and exosome transfer of proteins, nucleic acids and organelles are also being recognized to play key roles. This review focuses on new insights on the cellular and signaling mechanisms underlying adipose tissue angiogenesis, and on their impact on obesity and its pathophysiological consequences.