ACAN and Autoimmunity: In another study, researchers found that a molecular complex of fibronectin and aggrecan from the epidural lavage predicts response to lumbar epidural steroid injection for radiculopathy with herniated nucleus pulposus.[23] To sum up, we hypothesize that the local intervertebral and nerve root canal irrigation may be able to change the release of inflammatory cytokines and trigger the autoimmunity in irrigated intervertebral disc and nerve root canal.