TNF and obesity due to melanocortin 4 receptor deficiency: Obesity is a recognized factor in the development of asthma, as evidenced by a study showing that various obesity indicators and IR are associated with wheezing and asthma-like symptoms.[10] The chronic inflammatory state associated with obesity features dysregulated production of multiple inflammatory mediators, including Toll-like receptor 4, tumor necrosis factor-α, and IL-6.[28] Adipokines, secreted by adipose tissue, trigger the innate immune response in adipocytes, leading to sustained inflammation.