LPS constitutes the outer membranesof most Gram-negative bacteria.54 Gram-negativebacterial families, such as Corynebacteriaceae, Pseudomonadaceae, and Enterobacteriaceae, are enriched in the CKD population.8,9 LPS activatesthe NF-κB pathway and mTOR signaling in macrophages to stimulatethe production of proinflammatory cytokines (IL-β1, TGF-β1,MCP-1, and TNF-α), leading to the CKD progression with kidneyinflammatory injuries and fibrosis.55,56. The gene discussed is TGFB1; the disease is chronic kidney disease.