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Study Design:Macrophageinhibitionfactor(MIF)modulatestheactivityofmatrixmetalloproteinases(MMPs)tocontrolthemetabolismof extracellularmatrixhumandegeneratedcartilageendplate(CEP)viatwosignalingpathway,extracellularsignal-regulatedkinase(ERK)or3-kinase(PI3K)/Akt.