Exosomes derived from CESCs, however, can activate HIF-1α/Wnt signaling via autocrine mechanisms to increase the expression of GATA4 and TGF-β1, thereby promoting the migration of CESCs into the IVD and the transformation of CESCs into NP cells and inhibiting IDD [69]. Here, TGFB1 is linked to intervertebral disk degenerative disorder.