Bone homeostasis is regulated through osteoclast resorption and osteoblast formation, mediated by cytokines such as TGF-β and IGF-1.49,50 Overactivity of osteoclasts can disrupt this balance, leading to uncoupling and pain in degenerative diseases like osteoarthritis and LBP. The gene discussed is TGFB1; the disease is osteoarthritis.