In addition, previous studies revealed that human IAPP (hIAPP) has the function of promoting the secretion of IL-1β, IL-1α, and TNF-α by activating macrophages in vitro,17,18 all of which have been shown to be closely associated with IDD through degradation of ECM.19–21 If IAPP has a predominant role in IVD degeneration, it may be a good target for designing successful therapies. Here, TNF is linked to intervertebral disk degenerative disorder.