TNF and obesity due to melanocortin 4 receptor deficiency: This is consistent to some extent with a previous study from our group where we demonstrated that PBMCs isolated from individuals with obesity and T2D produced less IL-2, TNF-α, and IL-6 when stimulated with phytohemagglutinin (another T-cell mitogen) than individuals with obesity who were metabolically healthy and this, despite having a higher proportion of helper T-cell expressing CD278 which plays a role in IL-2 synthesis and T-cell proliferation (3, 36).