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It is also likely the SM-HLCs have alterations in metabolic gene expression with resultant changes of TCA cycle/glycolytic/mitochondrial intermediates that are geared towards high proliferation, high plasticity and dedifferentiation

9 Gradual collagenization and calcification of the nucleus occurs, resulting in the degradation and reduction of ECM components in both the AF and NP

This discrepancy may stem from differences in study populations, and both studies are limited by small sample sizes, making it difficult to exclude confounding effects of baseline microbiota composition, disease duration, and intervention duration

Furthermore, peptides typically exhibit poor membrane permeability [121]