TGFB1 and osteoporosis: Additionally, previous reports have indicated that elevated TGF-β1 in patients with chronic inflammation can affect osteogenesis by activating the TGF-β/Smad 2/3 pathway [80, 81], suggesting that the chronic inflammatory state observed in osteoporosis may also promote TGF-βR2 expression through certain mechanisms, thereby activating the TGF-β pathway and mediating injury to MSCs.