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To elucidate how obesity impacts pancreatic immune homeostasis, we performed spatial, transcriptomic and functional profiling of human pancreatic immune cells from obese and non-obese organ donors. Obesity was associated with higher density of tissue resident memory T-cells (TRM) in the exocrine pancreas which display high cytotoxic functions and aggregated around macrophages. Single cell sequencing of pancreatic macrophages revealed two main subsets - FOLR2\n                  <jats:sup>+<\/jats:sup>\n                  CD11c\n                  <jats:sup>\u2212<\/jats:sup>\n                  fetal-derived macrophages with pro-repair and immunoregulatory function and a FOLR2\n                  <jats:sup>\u2212<\/jats:sup>\n                  CD11c\n                  <jats:sup>+<\/jats:sup>\n                  monocyte-derived macrophages with greater T-cell interactions and pro-inflammatory function. In obesity, the pancreatic macrophage landscape shifts to lower predominance of FOLR2\n                  <jats:sup>+<\/jats:sup>\n                  CD11c\n                  <jats:sup>\u2212<\/jats:sup>\n                  macrophages and higher FOLR2\n                  <jats:sup>\u2212<\/jats:sup>\n                  CD11c\n                  <jats:sup>+<\/jats:sup>\n                  macrophages which interact selectively with the TRM and inflamed exocrine epithelium. Together, these results identify macrophage-T cell circuits and immune epithelial interactions that fuel chronic pancreatic inflammation in obesity \u2013 a potential unifying mechanism for obesity-related pancreatic diseases.\n                <\/jats:p>","DOI":"10.1101\/2025.07.14.664803","type":"posted-content","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T19:00:19Z","timestamp":1752865219000},"source":"Crossref","is-referenced-by-count":1,"title":["Dynamic remodeling of the pancreas immune landscape in obesity"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3583-3136","authenticated-orcid":false,"given":"Alexey","family":"Koshkin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8725-5932","authenticated-orcid":false,"given":"Kranthi Kiran 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