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. Here, TLR4 is linked to necrotizing enterocolitis.