Objective. Members of the transforming growth factor  (TGF) cytokine superfamily play critical roles in both homeostasis and disease. In light of their profibrotic effects, these molecules are implicated in the pathogenesis of fibrosis. In fibroblasts, TGF signals through the activin receptor-like kinase 5 (ALK-5) type I TGF and triggers Smad and MAP kinase signaling pathways. Because targeting of TGF signaling represents a potential approach to the treatment of systemic sclerosis (SSc) and other fibrotic disorders, we investigated the modulation of intracellular TGF signal transduction by SB431542, the first small-molecule inhibitor of ALK-5 to be described.Methods. Ligand-induced activation of the Smad signaling pathway in human dermal fibroblasts was examined by Western blot analysis and confocal immunocytochemistry. Modulation of profibrotic gene expression was investigated using Northern blot analysis, transient transfection assays, and confocal microscopy. Induction of TGF production was evaluated by enzyme-linked immunosorbent assay.Results. SB431542 abrogated TGF-induced phosphorylation and nuclear importation of endogenous Smad2/3 and Smad4, and inhibited Smad3-and Systemic sclerosis (SSc) is a chronic disease of unknown etiology characterized by autoimmunity, vascular damage, and progressive fibrosis of the skin and internal organs. The pathogenesis of fibrosis is not well understood, and there are no effective treatments. Fibroblasts from lesional tissues show evidence of activation, with increased synthesis of collagen, fibronectin, tissue inhibitor of metalloproteinases 1 (TIMP-1), and plasminogen activator inhibitor 1 (PAI-1); secretion of profibrotic cytokines such as transforming growth factor Supported by grants from the NIH (AR-42309) and the Scleroderma Foundation.