Decreased thrombomodulin expression in the endothelial glycocalyx is attributed to reduced transcription and translation induced by pro-inflammatory cytokines such as TNF-α (132), or through cleavage by neutrophil proteinases, with a concomitant increase in soluble thrombomodulin in serum, plasma and urine in patients with renal disease including LN (53, 133–135). Here, TNF is linked to lobular neoplasia.