TNF and necrotizing enterocolitis: The imbalance between protective anti-inflammatory cytokines and proinflammatory mediators is considered a key contributor to intestinal dysbiosis in NEC.27 An increased expression of IL-6, TNF-α, and IL-1β has been reported in murine NEC intestines.28 Moreover, Li and Sheng29reported a significant elevation in the serum concentrations of TNF-α and IL-6 in neonates with NEC, with the peak observed at 24 hours.