Gut Microbiota and NLRP3 Inflammasome Activation in Hemodialysis Patients: Exploring the Link with Systemic Inflammation

Background The Nod-Like Receptor Pyrin domain-containing 3 (NLRP3) inflammasome is a critical sensor of bacterial signals and metabolites, initiating an inflammatory response. Chronic kidney disease (CKD) is often accompanied by systemic inflammation, which can be involved with gut dysbiosis. Considering this interplay, we aimed to explore the potential association between NLRP3 inflammasome expression and gut microbiota in CKD patients undergoing hemodialysis (HD). Methods and results This research comprises a cross-sectional pilot study involving twelve HD patients [59.2 ± 13.4 years, six women, BMI 26.6 ± 3.5 kg/m ² , 48.6 (20.1–77.2) months on dialysis]. The gut microbiota was evaluated by the 16S ribosomal RNA gene. The mRNA expression of NLRP3 was assessed using real-time quantitative polymerase chain reaction (qPCR). Plasma levels of IL-1β were measured by ELISA. A positive correlation between mRNA expression of NLRP3 and Lentisphaerae phylum and with Erysipelaloclostrium and Victivallis genus (p < 0.05) was observed. The IL-1β mRNA expression was positively correlated with Lentisphaerae and Spirochaetes phylum. Also, there was a positive correlation with the relative abundance of the genera Erysipelaloclostrium, Absicoccus, Colidextribacter, Desulfovibrio, Fournierella, Lawsonibacter, Ruminococcus , and Victivallis. Regarding Archaea, IL-1β mRNA expression was positively correlated with Methanobrevibacter. Conclusion In CDK patients undergoing hemodialysis, gut microbiota may be involved in NLRP3 activation and IL-1β expression, contributing to inflammation.