Signaling pathways activated by thrombopoietin. A stylized drawing of c-Mpl is shown in the activated (phosphorylated) form. Once phosphorylated, Tyr₁₁₂ serves as a docking site for STAT3 and STAT5, both activated by thrombopoietin in megakaryocytes, which leads to production of Bcl-x_L, among other antiapoptotic and pro-proliferative signaling molecules. The same site also serves to recruit SHC, which in turn recruits Grb2 and SOS (the latter a guanine nucleotide exchange factor for Ras), exchanging GTP for GDP, and thereby activating Ras. In succession, a MAPKKK (MAPK kinase kinase, e.g., Raf), a MAPKK (MAPK kinase), and the MAPK ERK1/2 or p38 MAPK are recruited and activated. As shown, Raf activation also contributes to PI3K activation. At a site proximal to Tyr₁₁₂, a complex containing the phosphatase SHP2, the adapter protein Gab1, and the regulatory subunit of PI3K (p85) forms upon phosphorylation by JAK2, which recruits the kinase subunit of PI3K (p110), leading to phosphorylation of cell membrane–bound phosphoinositol_4,5 biphosphate (PIP₂) and thus generating phosphoinositol_3,4,5 triphosphate (PIP₃). PIP₃ then recruits pleckstrin homology domain–containing proteins, including the Ser/Thr protein tyrosine kinase Akt. Once activated at the cell membrane, Akt phosphorylates (and inactivates) GSK3β, which also promotes cell proliferation. Akt also phosphorylates the transcription factor FOXO3a, leading to its nuclear exit and thus precluding its induction of the cell cycle inhibitor p27. Inhibition of cell signaling is also initiated by JAK activation; shown in red is the transcriptional regulation of SOCS proteins by STATs, and their subsequent blockade of signaling by preclusion of signaling molecule docking to P-Tyr residues of the receptor or their JAK-induced phosphorylation.