On the other hand, the activation of inflammatory pathways, such as the NF-κB pathway, by TLR4 results in increased production of TNF-α, which binds with TNFR1 to activate RIPK1-mediated necroptosis.9 This study confirmed the increase in TNF-α after NEC induction. This evidence concerns the gene TLR4 and necrotizing enterocolitis.