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27 Compared with other cell therapy approaches that utilize autologous NP or stem cell injection on the basis of restoring the number of functional NP cells to degenerative IVDs in order to initiate IVD regeneration, 28 fibroblast therapy was found with our results to instead induce NP cells to adopt a fibrotic phenotype, possibly participate in reparative fibrosis and tissue healing processes via TGF/Smad signaling