Nevertheless, existing literature points to intestinal dysbiosis in NEC that results from an imbalance between pro-inflammatory mediators such as Toll-like receptor (TLR)4, interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF) and IL-18 on the one hand, and protective anti-inflammatory mediators such as TLR9, IL-1 receptor antagonist (IL-1Ra), IL-10 and transforming growth factor (TGF)β2 on the other12. This evidence concerns the gene IL18 and necrotizing enterocolitis.