GPR18 and obesity due to melanocortin 4 receptor deficiency: CD8+ senescent T and late memory B cells are highly inflammatory, secrete cytotoxic mediators and express natural killer cell receptor.58,59 Higher frequencies of CD8+ senescent T and late memory B cells, along with long-term activation of myeloid cells, are often seen in the context of a low-grade systemic inflammation, a key pathophysiological component of atherosclerotic cardiovascular disease, obesity and of neurodegenerative disorders.60,61 Our study confirms the upregulation of GPR18 in senescent T and B cells from pwALS and specifically in fast-progressing and bulbar onset patients.