MMP9 and neoplasm: In fibroblasts and macrophages, IL-1/-2/-6 and TNF-⍺ can all induce MMP2 and MMP9 expression via MAPK.62 Many of the DEGs in our model were also linked to MAPK signaling, which has well-known roles in regulating tumor differentiation and tissue invasion.63 Taken together, our results provide several mechanistic insights into how MMP9 activity could mediate adherent VS development.