Beyond thrombosis: the role of platelets in cardiovascular, oncological, and immune-related inflammatory diseases

Platelets are anucleate cells derived from megakaryocytes that play a vital role in hemostasis through glycoprotein-mediated adhesion and coagulation. Their pathophysiological functions extend across cardiovascular, oncological, and inflammatory disorders. In cardiovascular diseases, activated platelets interact with endothelial and smooth muscle cells by delivering inflammatory mediators and microRNAs, thereby modulating vascular remodeling. In addition, tumor-educated platelets facilitate metastasis by transferring mitochondria via tunneling nanotubes, expressing immune checkpoint molecules such as programmed death-ligand 1, and releasing angiogenic factors like vascular endothelial growth factor. Furthermore, platelets coordinate immune responses through receptor-mediated signaling and the release of cytokines, as well as factors that induce neutrophil extracellular traps. Emerging single-cell proteomic and transcriptomic analyses have identified disease-specific signaling components in platelets, revealing potential diagnostic and therapeutic targets for platelet-associated diseases. This review highlights recent advancements on the pathophysiological roles of platelets and their therapeutic implications in cardiovascular, oncological, and immune-related inflammatory diseases.