Transforming growth factor betas are a group of polypeptide growth factors that have a wide range of activities in the musculoskeletal and immunological systems. They are thought to play an important role in the development, induction, and repair of bone. This family of closely related genes includes the five known transforming growth factor betas and also the bone morphogenetic proteins. With the development of new techniques to analyze gene expression, the broad range of cellular activities regulated by transforming growth factor beta is beginning to be understood. The critical role that transforming growth factor beta plays in the regulation and stimulation of mesenchymal precursor cells for chondrocytes, osteoblasts, and osteoclasts is now emerging based on a series of in vitro studies. Although transforming growth factor betas appear to stimulate proliferation of precursor cells, it appears that transforming growth factor betas have an inhibitory effect on mature cell lines. In vivo studies indicate the presence of transforming growth factor beta protein and transforming growth factor beta gene expression in normal fracture healing, whereas exogenous transforming growth factor beta administration stimulates the recruitment and proliferation of osteoblasts in fracture healing. Although the cascade of events that leads to bone formation and repair is not completely understood, transforming growth factor beta’s central role in the regulation of fracture healing is not disputed.

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