Emerging Roles of Megakaryocytes in Immune Regulation and Potential Therapeutic Prospects

Megakaryocytes (MKs) have traditionally been viewed as terminal hematopoietic cells responsible solely for platelet production. However, recent advances in imaging and single-cell transcriptomics have revealed substantial heterogeneity among MK populations and diverse functions beyond thrombopoiesis. MKs actively participate in innate and adaptive immunity, modulate the hematopoietic stem cell (HSC) niche, and adapt to physiological and pathological stimuli. Located in distinct anatomical sites such as bone marrow and lung, MKs exhibit compartment-specific specializations that enable them to serve as critical integrators of hemostatic, immune, and regenerative processes. Experimental models using human pluripotent stem cells and inducible MKs have enhanced mechanistic insights, while innovative bioreactor platforms and xenotransplantation strategies advance translational applications in platelet production and therapy. Furthermore, immune MK subsets derived from pluripotent stem cells show promising therapeutic potential for modulating inflammation and autoimmune diseases. Continued exploration of MK diversity, tissue-specific roles, and intercellular communication will unlock new opportunities for leveraging MK plasticity in regenerative medicine, immunotherapy, and hematologic disorders, repositioning these versatile cells as central players in systemic homeostasis and defense.