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The epithelialmesenchymal transition is governed by biochemical changes that allow specific epithelial cells to adopt a mesenchymal phenotype, acquire invasive capabilities, disseminate throughout the body, and resist stress (Ye and Weinberg 2015)

Some compensations for the proteoglycan loss in the NP with aging occurs by the cells laying down collagens which is more cross-linked, however, this renders the IVD stiffen with less dynamic compliancy under load (Vergroesen et al., 2015)

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