Inflammation appears to play a pivotal role in EV production, as demonstrated in a study by Viñuela-Berni et al. (2015), which reported increased levels of EVs in urine and blood samples from patients with lupus or rheumatoid arthritis; this study also showed that EVs stimulated the release of TNF-α and IL-1 in vitro. This evidence concerns the gene TNF and systemic lupus erythematosus.