In the disturbed gut microbiota of patients with DKD, overexpression of Gram-negative bacteria is accompanied by markedly elevated serum levels of the potent immunostimulant lipopolysaccharide (LPS), which correlates with inflammatory markers, such as interleukin 6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNFα) (17). Here, TNF is linked to diabetic kidney disease.