The focus on the role of TLR4 has been paid to the initial recognition and host response to gram negative bacteria (127) the Specifically, the mechanism of TLR4 involvement in NEC is described whereby the intestines of premature infants become colonized with gram-negative bacteria, which activate TLR4 and trigger pro-inflammatory downstream signaling cascades (128). This evidence concerns the gene TLR4 and necrotizing enterocolitis.