“…In previous studies, researchers used different in vitro cellular challenges (including IL-1β) ( Zhu L. et al, 2020 ; Li Z.-q. et al, 2020 ), high glucose ( Qi et al, 2019 ), LPS ( Zhang J. et al, 2020 ), advanced glycation end products (AGEs) ( Liao et al, 2019a ), hydrogen peroxide (H 2 O 2 ) ( Bari et al, 2018 ; Xia et al, 2019 ), TNF-É ( Cheng et al, 2018 ; Zhu G. et al, 2020 ; Yuan et al, 2020 ), tert-butyl hydroperoxide (TBHP) ( Xie et al, 2020 ), and acidic pH ( Li et al, 2020a )) to simulate the degenerative microenvironment. For these biochemical challenges, exosomes produced from MSCs have been shown to have a protective impact on NPCs via the mechanism of increasing the expression of chondrocytes, aggrecan, and collagen II in the extracellular matrix and decreasing matrix disintegration via the mechanism of the down-modulation of matrix-degrading enzymes.…”