“…Mutant HSCs can also perturb the well-balanced vascular niche by upregulating several targets involved in neo-angiogenesis (e.g., VEGF and angiopoietin-1) and fibrogenesis (e.g., TGF-β1, CXCL4, PDGF, IL-1β and TNF-α), in order to establish a permissive and nourishing milieu [ 80 , 81 , 82 , 83 ]. In particular, TGF-β1, whose levels are inherently linked to megakaryocytic activity, can induce fibrosis by (i) skewing the activity of MSCs towards fibroblastic and osteoblastic genesis and (ii) increasing the deposition of collagen [ 55 , 84 , 85 ]. Furthermore, evidence from in vitro experiments on PMF models portrayed CXCL4 as a major artificer of BM fibrosis, being able to (i) upregulate pro-fibrotic pathways in megakaryocytes, (ii) induce glioma-associated oncogene homolog 1 (Gli1)+ MSC migration and differentiation into myofibroblasts and (iii) amplify JAK/STAT activation in both megakaryocytes and MSCs [ 86 ].…”