Proceedings of the International scientific and practical conference ― Cambridge Science and Education Conference‖ (February 23-25, 2026) / Publisher website: www.naukainfo.com. – Cambridge, United Kingdom, 2026. - 289 p.

77 The balance of PGI₂ vs TXA₂ is critically important: normally they balance each other, but in MPN, the thromboxane pathway often prevails → thrombosis. Thus, the imbalance between excess PGE₂ and the predominance of TXA₂ over PGI₂ is a key pathogenetic mechanism in MPN [9]. In polycythemia vera, prostaglandins are important in the formation of the clinical picture and complications. PGE₂: Supports microinflammation in the bone marrow, promotes angiogenesis and survival of pathological clones, may be involved in itching (aquagenic pruritus), since prostaglandins are involved in the sensitization of nerve endings. TXA₂ (thromboxane A₂): Increased synthesis in platelets → platelet aggregation, vasoconstriction, an important factor in the high risk of thrombosis in SP. PGI₂ (prostacyclin): Normally counteracts thromboxanes, causes vasodilation and inhibits platelet aggregation, in SP its level is often reduced, which disrupts the balance and contributes to thrombotic complications. In essential thrombocythemia (ET), prostaglandins are involved in the formation of microvascular symptoms and thrombotic complications, although their role is less pronounced than in SP. PGE₂: May be moderately elevated, stimulates angiogenesis and proliferation of megakaryocytes, promotes microinflammation, which supports pathological clonal activity. TXA₂ (thromboxane A₂): Excessive production by platelets → microthrombosis, impaired microcirculation, a key factor in the development of headache, paresthesia, ischemic episodes. PGI₂ (prostacyclin): Normally counteracts TXA₂, but in ET its effect is often insufficient. A decrease in PGI₂ increases the risk of thrombosis. In myelofibrosis, PGs play a particularly important role in maintaining chronic inflammation, stimulating fibrosis and forming an immunosuppressive microenvironment.