Studies indicate that macrophage polarization exhibits a dual role in the IDD microenvironment: M1 macrophages aggravate ECM degradation and inhibit nucleus pulposus (NP) cell proliferation through the secretion of pro-inflammatory cytokines such as TNF-α and IL-1β, whereas M2 macrophages mitigate disc degeneration by releasing anti-inflammatory cytokines and growth factors (Li et al., 2022; Zhang H. et al., 2020). The gene discussed is TNF; the disease is intervertebral disk degenerative disorder.