Obesity increases the severity of immune-driven diseases, including atopic disorders and asthma, and patients with obesity often fail to respond to therapies that are effective in lean patients. Bapat et al. now report that obesity shifts the classical T helper 2 (T_H2)-type disease seen in atopic dermatitis (AD) to a more severe disease characterized by an exaggerated T_H17-type inflammation and resistance to therapies targeting the T_H2 axis. ?o explore how obesity affects atopic disease, the authors subjected obese mice and lean controls to a model of AD induced by applying the vitamin D analogue MC903 to the ear. Compared to lean controls, obese mice developed an exaggerated inflammatory response that was characterized by increased ear thickening, erythema and leukocyte infiltration. Obesity also exacerbated disease in a second model of AD and in a model of allergic airway inflammation.
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