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Figure 4 4.1.3 Targeting HIFP As mentioned above, HIFP is mainly caused by tumor hypoperfusion and increased leakage due to non-functioning blood vessels and lymphatics within the tumor, deposition of ECM components, and interstitial fibrosis

Paracrine signaling provides alternative mechanisms: Conditioned media from umbilical cord mesenchymal stem cells (UCMSC-CM) restores stemness in degenerated NP cells and enhances NPPC differentiation [94], while exosomes from normal nucleus pulposus progenitor cells (N-NPSC-exo) transfer microRNAs that support AF cell growth and disc repair (Fig