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6.6 Inflammatory cytokines and proteinases During intervertebral disc degeneration (IDD), the formation of an inflammatory microenvironment is a core pathological feature (Zheng et al., 2024), but when the AF is damaged, NP antigens are exposed, activating an autoimmune response, leading to infiltration of immune cells such as macrophages and T lymphocytes, and the release of numerous inflammatory mediators (Wang et al., 2024