On treatment with TPO-RAs, which results in elevated platelet counts, platelet-derived TGF-β reprograms myeloid-derived suppressor cells (MDSCs) in ITP. This leads to restoration of the immune disbalance in ITP and initiates immunosuppression via MDSC. Figure adapted from Semple and Kapur.8 Arg-1, arginase-1; ASC, antibody-secreting cells; PD-L1, programmed cell death 1 ligand; Th1, T helper cell 1.
