TLR4 can bind with TRIF (Toll/interleukin-1 (IL-1) receptor-domain-containing adaptor inducing interferon-β (IFN-β)) and then with receptor-interacting protein kinase 3 (RIPK3) to induce necroptosis.9 This finding suggests that the high level of TLR4 in NEC activates intestinal epithelial cell necroptosis, contributing to barrier dysfunction and local inflammation. The gene discussed is RIPK3; the disease is necrotizing enterocolitis.