LTBP1 (latent transforming growth factor beta binding protein 1) is a key extracellular matrix regulator that controls TGF-β activation by maintaining it in a latent, inactive state 1. LTBP1 associates specifically with the latency-associated peptide (LAP) via disulfide bonds, forming large latent complexes that sequester TGF-β in the extracellular space and regulate integrin-dependent TGF-β activation 1. Beyond TGF-β regulation, LTBP1 participates in microfibril assembly and extracellular matrix organization, and its expression levels serve as markers of disease progression in cardiovascular and fibrotic conditions 23. Clinically, LTBP1 dysregulation is implicated in multiple pathologies. In atherosclerosis, LTBP1 marks fibromyocyte/fibrochondrogenic smooth muscle cell phenotypes associated with disease progression 2. Excessive LTBP1 expression promotes lung fibrosis through collagen deposition and TGF-β signaling activation 3. In postischemic stroke epilepsy, LTBP1 upregulation stimulates epileptic cell proliferation via TGF-β/SMAD pathway activation and inflammation 4. In hepatocellular carcinoma, LTBP1 elevation through HNRNPA1 dysregulation increases TGF-β secretion and promotes tumor progression and immunotherapy resistance 5. Conversely, LTBP1 lactylation enhances collagen synthesis in skin fibroblasts, supporting tissue rejuvenation 6. Mutations affecting LTBP1 binding to fibrillin-1 impair TGF-β signaling and contribute to aortic dissection pathology 7.