Tissue-Specific Chemerin in Atherosclerosis

Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of disability-adjusted life years (DALYs) and all-cause mortality worldwide, imposing an increasing global health burden. Atherosclerosis (AS) is a complex multifactorial disease, and the concept of organ crosstalk has provided a new perspective for understanding its pathogenesis. Although circulating chemerin levels are closely associated with the development and adverse prognosis of ASCVD, the functional heterogeneity and regulatory characteristics of chemerin derived from different tissues have not been systematically investigated. This review elucidates the tissue-specific roles of chemerin in AS from both endocrine and paracrine perspectives, with a focus on chemerin derived from the liver, white adipose tissue, perivascular adipose tissue, and epicardial adipose tissue. Endocrine chemerin primarily contributes to systemic metabolic dysfunction and endothelial injury, whereas locally produced chemerin regulates vascular smooth muscle cell remodeling and vascular inflammation through paracrine signaling. Collectively, endocrine and paracrine chemerin constitute a dual regulatory network that links metabolic abnormalities with vascular remodeling during AS progression.