TNF and diabetic kidney disease: GLP-1 receptor agonists also downregulate the expression of several proinflammatory biomarkers in animal models with diabetic nephropathy, such as TNF-alpha, collagen I, fibronectin, monocyte chemoattractant protein-1(MCP-1), and alpha-smooth muscle actin (α-SMA), and reduce the proinflammatory reaction by inhibiting accumulation of inflammatory cell, blocking profibrotic signaling and the activation of the mononuclear phagocyte system [1,32,118].