Based on our previous finding that both PRRX1 and COL6A3 showed increased adipose expression after bariatric surgery in people with extreme obesity concomitant with markedly reduced inflammation17, we hypothesized that TNF-α reduces COL6A3 mRNA, at least in part via reduced PRRX1. This evidence concerns the gene PRRX1 and obesity due to melanocortin 4 receptor deficiency.