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However, since there are relatively few cells in the degenerated IVD and cell viability is impaired, stimulation of the remaining cells may be insufficient to achieve repair [13]

Such an imbalance is responsible for severe damage to essential biomolecules, such as lipids (lipid peroxidation), proteins (oxidation and inactivation), and DNA (strand breakage and mutations), which is associated with the pathogenesis of numerous diseases, including cancer, neurodegenerative diseases, cardiovascular diseases, and the aging process [28]

The two are not the same, and the checks you run on each are different