Abstract:[Objective] To explore the effect of exosomes derived from rat cartilage endplate stem cells (CESC) on nucleus pulposus cells (NPC) and intervertebral disc degeneration (IVDD) . [Methods] The CESC and NPC were isolated and cultured from rat intervertebral disc. The Nor-Exos from normal CESC and Eld-Exos from high glucose induced aging CESC were extracted and purified by super centrifu- gation, and co-cultured with NPC, respectively. The Tunel staining and flow cytometry were used to detect apoptotic cells, while western blot was used to detect the protein expression levels of Bax, Bcl-2, Cyclin D1 and Cyclin D3 in NPC. In addition, 9 SD rats were randomly divided into three groups, namely blank control group, Nor-Exos group and Eld-Exos group. IVDD model was established by acupuncture method and corresponding treatment was given. MRI scan was performed 5 weeks after operation, and scores were marked according to Pfir- rmann criteria. [Results] In vitro, the cell apoptosis was ranked down-up in order of: blank control group < Nor-Exos group < Eld-Exos group, with statistically significant differences in term of total groups and pairwise comparison (P<0.05) . The protein expression of Bax was down-up of blank control group < Nor-Exos group < Eld-Exos group, whereas the expression levels of Bcl-2, Cyclin D1 and Cyclin D3 in ascending order were of Eld- Exos group < Nor- Exos group < blank control group, with statistically significant differences among total groups and pairwise comparison (P<0.05) . In vivo, Pfirrmann score was marked from low to high as blank control group < Nor- Exos group < Eld-Exos group, with statistically significant differences (P<0.05) . [Conclusion] The Eld-Exos does considerably promote apopto- sis of NPC, increase the presentation of apoptotic protein in intervertebral disc tissue, and accelerate the progression of IVDD.