HHcy directly acts on the endothelium by inducing an upregulation of IL-6, IL-8, TNF-alpha expression [235,236,237], together with cathepsins, involved in the endothelium-inflammatory and vascular remodeling processes [238,239], by influencing IL-6 and TNF-alpha [240,241,242,243,244,245] and enhancing the VEGF/ERK1/2 signaling pathway [240,241,242,243,244,245,246,247], which is a constant in the atherosclerosis process [247]. This evidence concerns the gene TNF and atherosclerosis.