TNF and obesity due to melanocortin 4 receptor deficiency: In obesity, adipocyte hypertrophy has been associated with increases of M1 macrophages (38) and increased gene expression of proinflammatory factors, such as TNFα (32, 38–41), or IL6 (32, 39–43), and a downregulation of IL10 (40) that is linked to M2-like polarization.