During IDD, the p38 MAPK mediates the increased expression of cytokine-induced catabolic enzymes in NPCs, such as ADAMTS-4, -5, and MMPs, which in turn can degrade ECM and lead to aggravation of IDD degree (Tian et al., 2013; Yang et al., 2016). The gene discussed is ADAMTS4; the disease is intervertebral disk degenerative disorder.