HMGB-1 participates in intestinal inflammation of NEC by inhibiting the NLR pyrin domain containing 3 via Toll-like receptor 4 and nuclear factor-kappaB signaling pathways and decreases intestinal microcirculatory perfusion by rescuing nitric oxide production and eliminating oxygen production through endothelial nitric oxide synthase activation (23, 37). This evidence concerns the gene HMGB1 and necrotizing enterocolitis.