Studies on myocardial fibrosis, urinary carcinoma, and intervertebral disc degeneration found that Gremlin-1 can also directly antagonise TGFβ1 (Müller et al., 2021; Chen et al., 2022; Chan et al., 2023), thereby potentially exerting anti-fibrotic effects. Here, GREM1 is linked to Intervertebral disk degeneration.