“…Collagen II expression in the NP decreases with aging and degeneration [ 21 ]. Various animal model studies suggest that early IDD involves a transient increase in collagen II, changing gelatinous NP into a cartilaginous entity before further remodeling into fibrous tissue [ 25 , 49 ], characterized by an increase in collagen I. Accumulation of collagen I has been evidenced in human IDD [ 6 , 21 , 50 ], animal models of IDD induced by aging [ 6 , 21 , 25 , 49 , 50 , 51 ], overloading [ 52 ] or injury [ 6 , 26 , 36 , 49 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ], as well as NP cells under stress [ 36 , 50 ] or treatment of TGF-β [ 59 , 60 ]. Collagen III and collagen I are primary ECM components produced by myofibroblasts that are proposed to increase tissue stiffness and tensile force [ 61 ] and decrease tissue compressive strength.…”