CCL4 and intervertebral disk degenerative disorder: Shin et al. revealed that resistin could promote obesity-related inflammatory IDD by MAPK and NF-κB signaling pathways.45 Another study also validated the functions of resistin in promoting the ECM degradation in rat disc NP cells.46 Additionally, it has been also reported that resistin could induce chemokine ligand 4 (CCL4) expression by p38-MAPK and NF-κB signaling in rat NP cells, leading to macrophage infiltration to promote IDD.47