IL18 and obesity due to melanocortin 4 receptor deficiency: Collectively, the increased circulating levels of intestinal damage markers together with the downregulated expression of NLRP6 and IL18 and increased levels of pro-inflammatory factors in the jejunum from patients with obesity-associated T2D suggest a defective inflammasome sensing, driving to an impaired epithelial intestinal barrier and uncontrolled inflammation that may regulate the progression of multiple obesity-associated comorbidities (Fig. 7).