Consequently, the injured ECs may act as active signal transducers of inflammatory (IL-1, TNF-α), metabolic and hemodynamic factors (TGF-β) that modify the morphology and function of the vessel walls, potentially activating proliferative and inflammatory responses in DKD (Monteiro et al., 2020; Nakagawa et al., 2004). This evidence concerns the gene TNF and diabetic kidney disease.