IGHE and obesity due to melanocortin 4 receptor deficiency: Obesity induces a state of chronic low-grade inflammation characterized by elevated adipokines (e.g., leptin) and proinflammatory cytokines (e.g., TNF-α and IL-6) [15], which promote airway hyperreactivity, increase mucosal permeability, and amplify IgE-mediated responses to occupational allergens.