There is substantial molecular evidence for the involvement of betal integrin in tissue organisation and remodelling, which confers a key role in cell growth, differentiation, migration, and survival. This role has been, in part, highlighted using the transgenic approach which does little to define the more subtle functions such as those controlled by avidity regulation. Upon activation integrins in general, including betal integrin, are known to exhibit global structural rearrangement and exposure of ligand binding sites. Recent evidence has revealed a role of betal integrin modulation in tissue repair and regeneration. The anomalies and phenomena describing the roles of betal integrin in tissue remodelling are reviewed, as well as the tools which have been used to define the functions of betal integrin and its impact on our understanding of the diverse roles of betal integrin in remodelling. This eclectic mix of phenomena is conceptualised to form a unified hypothesis of a novel understanding of both tissue injury and repair. (C) 2008 Elsevier Inc. All rights reserved.