TLR4 activation induces necroptosis in the newborn ileum in the pathogenesis of NEC. (A) qRT-PCR of ileal inflammatory (Il6) and necroptosis (Ripk1, Ripk3, and Mlkl) genes in WT and Tlr4-/- background in response to LPS. (B) qRT-PCR of the same genes as in panel A, but in a wild-type or Tlr4- NEC model. C34 is a TLR4 inhibitor. (C) qRT-PCR of ileal inflammation and necroptosis genes in WT or Tlr4- mice administered TNFα to induce necroptosis. (D) Confocal immunofluorescence staining of pRIPK3 in the ileum of WT or Tlr4- mice with or without NEC, or during NEC when given C3. Arrows highlight necroptotic cells. Scale bar: 30 μm. ∗P < .05, ∗∗P < .05, and ∗∗∗P < .005. Each dot is a separate sample. Representative of 3 separate experiments. Ctrl, control; DAPI, 4′,6-diamidino-2-phenylindole; Ecad, E-cadherin; WT, wild type/C57Bl/6.