It was also reported that the TRPV4/Ca2+ pathway was involved in the “obesity paradox” (obesity was associated with a better prognosis in patients ventilated for ARDS).The data indicated that VILI could be attenuated in mice fed a high-fat diet and in pulmonary microvascular endothelial cells treated with adipose-derived exosomes through the TRPV4/Ca2+ pathway (59). This evidence concerns the gene TRPV4 and obesity due to melanocortin 4 receptor deficiency.