A neurovascular template guides the spatial and functional compartmentalization of the adrenal gland

The vasculature adapts to tissue demands, but whether it can instruct spatial tissue organization remains unclear. In the developing adrenal gland, we uncover a neurovascular mechanism that actively establishes and preserves compartment boundaries between cortex and medulla. Peripheral nerves secrete Semaphorin3C, signaling through PlexinD1 on endothelial cells to locally antagonize VEGF-driven angiogenesis from cortical cells, sculpting distinct vascular domains that guide hormone-producing cells to their correct territories. Disruption of this balance -via denervation or loss of Semaphorin3C-PlexinD1 signaling- leads to ectopic vascularization of the medulla, which adopts a cortex-like vascular network. This vascular remodeling enables cortical cells invasion of medullary territories, blurring compartment boundaries and triggering a phagocytic macrophage response that reflects pathological hijacking of a postnatal morphogenesis program. Our findings reveal that region-specific vascular scaffolds, shaped by neurovascular cues, serve as instructive templates for organ architecture. Failure of neurovascular signaling can thus trigger a cascade of structural collapse that undermines tissue integrity and homeostasis, driving pathological remodeling.