TNF and neoplasm: M1 macrophages are typical activated cells that secrete so much pro-inflammatory cytokines (IL-1β, iNOS, and TNF-α), Chemokine (MCP-1) and reactive oxygen species promote inflammatory responses that cause additional damage during the pathogenesis of DN.[35] M2 macrophages frequently function as immunosuppressive cells involved in anti-inflammatory responses, tissue remodeling, and tumor progression.[61] Therefore, our focus was on the significant increase of M1 macrophages observed in glomerular samples obtained from patients with DN.