Level 3 confirmation. Human IL-18BP is secreted mostly by hepatocytes and macrophages in the liver. The binding protein binds the pro-inflammatory IL-18 and to a lesser extent also the anti-inflammatory IL-37 cytokine. Inherited IL-18BP deficiency underlies hepatitis by unleashing IL-18 (Belkaya et al., 2019). The IL-18/IL-18BP balance plays a role in several metabolic disorders, such as obesity, diabetes, and atherosclerosis, however, the exact mechanism is yet elusive (Kaplanski, 2018). This evidence concerns the gene IL37 and obesity due to melanocortin 4 receptor deficiency.