THBS1 (thrombospondin-1) is a multifunctional adhesive glycoprotein that mediates cell-to-cell and cell-to-matrix interactions through multiple receptor pathways, including CD47, CD36, and SIRPA 12. Beyond its canonical role as an angiogenesis inhibitor, THBS1 regulates diverse physiological processes including inflammation, wound healing, ROS signaling, apoptosis, and cellular senescence 34. THBS1 negatively modulates dendritic cell activation via CD47-mediated autocrine feedback, contributing to immune homeostasis 3, while also suppressing antitumor immunity through CD47-dependent regulation of innate and adaptive immune cells 5. In pathological contexts, THBS1 plays critical roles in disease progression. In colorectal cancer, monocyte-derived THBS1 promotes immunosuppression and metastasis by inducing T-cell exhaustion 6. In glioblastoma, tumor-secreted THBS1 acts as a synaptogenic factor that remodels neural circuits and promotes tumor proliferation; gabapentin-mediated THBS1 inhibition reduces glioblastoma growth 7. THBS1 impairs wound healing in cancer survivors through sustained epigenetic priming in post-radiation fibroblasts, with anti-THBS1 antibodies promoting wound closure 8. In cerebral ischemia-reperfusion injury, macrophage-derived exosomal THBS1 induces endothelial ferroptosis via the THBS1-OTUD5-GPX4 axis 9. Conversely, THBS1 downregulation in preeclampsia promotes trophoblast necroptosis through NEDD4-mediated TAK1 ubiquitination 10. THBS1 dysfunction in meningeal lymphatic endothelial cells after subarachnoid hemorrhage involves STAT3/Bcl-2 signaling dysregulation 11.