TNF and inflammatory response: In the context of vascular dysfunction, PVAT mostly produces and releases pro-inflammatory adipokines, such as leptin, tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1, also known as CCL2), RANTES (Chemokine C-C motif ligand 5, CCL5), interleukin-6 (IL-6), and interleukin-1β (IL-1β); all of these factors can directly affect VSMCs and ECs, thus triggering and coordinating vascular inflammation (Figure 1B) (5, 9).