Multi-functional platelets: translating biological functions into therapeutic applications

Platelets, produced by megakaryocytes, extend far beyond their traditional roles in hemostasis and thrombosis. Emerging study indicates that platelets actively participate in multiple physiological and pathological processes through diverse activities, such as modulating immune responses, facilitating tissue regeneration, and contributing to the remodeling of disease-associated microenvironments. This review systematically summarizes the biological basis of platelets (including generation, activation, release and aging) and analyzes their interaction with hemostasis, inflammation, and injured tissues, providing the foundation for advanced therapy. Building on this foundation, we focus on two dimensions and summarize the advanced progress: 1) Platelets-targeting therapeutic strategies, including precise intervention in anti-tumor therapy (inhibiting metastasis and immune escape), cardiovascular diseases (modulating thrombosis and vascular stenosis), and emergency hemostasis (enhancing coagulation efficiency); 2) Engineering construction and targeted delivery using platelets and their derivatives (PRP, extracellular vesicles, membranes, and platelet-mimicking materials), which leverage their intrinsic bioactivity and multi-targeting capabilities. By bridging platelet biology to therapeutic innovation, this review provides a framework for understanding disease mechanisms and developing next-generation targeted therapies.