Furthermore, the induction of HO-1 in the tubular epithelium in proteinuric states that occurs in cases of LN cannot be simply ascribed to increased trafficking of albumin per se across the proximal tubule; such expression more likely reflects concomitant injury to tubular epithelial cells occurring pari passu with glomerular disease and/or the pro-inflammatory, pro-oxidant, or other perturbing effects of specific proteins or other species appearing in the urinary space, as it has been demonstrated by some authors (67). This evidence concerns the gene ALB and lobular neoplasia.