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The phenotype of macrophages in the local immune microenvironment greatly influences the balance of ECM metabolism. Therefore, the control over the macrophage phenotype of the ECM is promising to repair intervertebral disk degeneration. Herein, the preparation of an injectable nanocomposite hydrogel is reported by embedding epigallocatechin\u20103\u2010gallate\u2010coated hydroxyapatite nanorods in O\u2010carboxymethyl chitosan cross\u2010linked with aldehyde hyaluronic acid that is capable of modulating the phenotype of macrophages. The bioactive components play a primary role in repairing the nucleus pulposus, where the hydroxyapatite nanorods can promote anabolism in the ECM through the nucleopulpogenic differentiation of mesenchymal stem cells. In addition, epigallocatechin\u20103\u2010gallate can decrease catabolism in the ECM in nucleus pulposus by inducing M2 macrophage polarization, which exists in normal intervertebral disks and can alleviate degeneration. The nanocomposite hydrogel system shows promise for the minimally invasive and effective treatment of intervertebral disk degeneration by controlling anabolism and catabolism in the ECM and inhibiting the IL17 signaling pathway (M1\u2010related pathway) in vitro and in vivo.<\/jats:p>","DOI":"10.1002\/advs.202304480","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T15:40:06Z","timestamp":1699458006000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Decoding Macrophage Subtypes to Engineer Modulating Hydrogels for the Alleviation of Intervertebral Disk Degeneration"],"prefix":"10.1002","volume":"11","author":[{"given":"Da\u2010Wang","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Orthopedics Qilu Hospital of Shandong University  Jinan Shandong 250012 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