The global rise in adiposity has resulted in more than 1.9 billion adults being overweight and 650 million adults currently classified as obese. Areas that have seen a dramatic rise in obesity, have also seen a significant increase in emerging viral pathogens. Particularly regions of South and Central America have been hardest hit by this “double disease burden” (WHO). Excessive adiposity increases host susceptibility to viral infection and alters immune responses to vaccination. As has previously been observed for influenza and multiple other infections, obese individuals infected with SARS-CoV-2 have a significantly increased risk of developing more severe COVID-19 with longer hospital stays and poorer outcomes compared with non-obese individuals. As the world moves rapidly toward treatments for SARS-CoV-2 and continues to develop vaccination strategies for infections in adults, there is a concern that the protections afforded to a non-obese population will not be as efficacious in the obese population.

Some of the most cutting-edge research currently being done centers around studies to identify mechanisms responsible for the enhanced disease severity and poor vaccination outcomes associated with obesity. In obese humans and mice there are complex pathways of inflammatory cytokines, chemokine and innate cells not found in the non-obese which are thought to be involved in the induction of immune defects. Obesity is associated with alterations in immune cell populations within adipose tissue which alter the pro-inflammatory state. Furthermore, within the adaptive immune response there is evidence of immune dysfunction and reduced numbers of memory responses associated with obesity. Obesity associated inflammation also mediates changes to other organs including the heart, liver and lungs leading to poor cell function and enhanced susceptibility to injury and disease. Additionally, well documented epigenetic changes occurring in cells of obese individuals leading to alter outcomes in disease progression and severity as compared to the non-obese.

The aim of the Research Topic is to support compilation of studies addressing how obesity impacts vaccination and immunity to infections. Our aim is to gather articles on basic and clinical immunology, virology, microbiology, and vaccinology related to obesity, infection and vaccination. We welcome the submission of Original Research Articles, Review, Mini-Review, Hypothesis and Theory, and Perspective articles in the following areas:

1. Obesity-induced inflammation and its impact on vaccination and disease severity
2. Genetic factors associated with obesity which impact infection and disease
3. Animal models of obesity and infection or vaccination
4. Enhanced infectious disease severity associated with obesity
5. Vaccination outcomes in obese populations
6. Therapeutic or vaccines designed to improve efficacy in obese population
7. Separation of physiological and environmental impacts of obese patient outcomes

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Frontiers in Immunology

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