PTGS2 and Intervertebral disk degeneration: Zhang L. et al. (2018) demonstrated that andrographolide can reduce nucleus pulposus degradation induced by the pro-inflammatory cytokine IL-1β in patients with intervertebral disc degeneration via a TLR-4/MyD88/NF-κB-mediated signaling pathway, resulting in an anti-inflammatory effect. It has been suggested that andrographolide may exert anti-inflammatory properties by inhibiting the activation of P38 MAPKs and the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) (He et al., 2013).