CCL4 and obesity due to melanocortin 4 receptor deficiency: This study was a secondary analysis of a single-arm weight loss clinical trial for adults with obesity, which aimed to investigate the effects of ADF-LC on circulating immune response biomarkers that are modulated by obesity including PD-L1, CCL2, CCL4, IL-8, IL-1ra, IFNγ, CD40-L, and IP-10.