Estrogen receptor alpha (ERα) activation functions AF-1 and AF-2 classically mediate gene transcription in response to estradiol (E2). A fraction of ERα is targeted to plasma membrane and elicits membrane-initiated steroid signaling (MISS), but the physiological roles of MISS in vivo are poorly understood. We therefore generated a mouse with a point mutation of the palmitoylation site of ERα (C451A-ERα) to obtain membrane-specific loss of function of ERα. The abrogation of membrane localization of ERα in vivo was confirmed in primary hepatocytes, and it resulted in female infertility with abnormal ovaries lacking corpora lutea and increase in luteinizing hormone levels. In contrast, E2 action in the uterus was preserved in C451A-ERα mice and endometrial epithelial proliferation was similar to wild type. However, E2 vascular actions such as rapid dilatation, acceleration of endothelial repair, and endothelial NO synthase phosphorylation were abrogated in C451A-ERα mice. A complementary mutant mouse lacking the transactivation function AF-2 of ERα (ERα-AF2 0 ) provided selective loss of function of nuclear ERα actions. In ERα-AF2 0 , the acceleration of endothelial repair in response to estrogen-dendrimer conjugate, which is a membrane-selective ER ligand, was unaltered, demonstrating integrity of MISS actions. In genome-wide analysis of uterine gene expression, the vast majority of E2-dependent gene regulation was abrogated in ERα-AF2 0 , whereas in C451A-ERα it was nearly fully preserved, indicating that membrane-to-nuclear receptor cross-talk in vivo is modest in the uterus. Thus, this work genetically segregated membrane versus nuclear actions of a steroid hormone receptor and demonstrated their in vivo tissuespecific roles.fertility | vascular effects | nongenomic effects | genomic actions A lthough estrogens classically serve as reproductive hormones, they induce cellular responses in almost all tissues in mammalian species. The biological effects of estrogens, and particularly of 17β-estradiol (E2), are initiated by their binding to intracellular estrogen receptors (ERs), ERα and ERβ, which classically serve as nuclear transcription factors (1, 2). The ERs regulate the transcription of hundreds of genes in a cell-and tissue-specific manner through their two activation functions (AFs), AF-1 and AF-2. The roles of the activation functions of ERα have been studied in vivo using mice deleted for ERαAF-1 or ERαAF-2 (3-5). These results, in particular the two models of ERαAF-2 inactivation (4, 6), suggested that many physiological functions strongly rely on nuclear ERα and gene transcription regulation. However, in addition to the nuclear, termed "genomic actions of ER," the receptors stimulate rapid (from seconds to minutes), nonnuclear signal transduction, usually termed "nongenomic" or "extranuclear" effects. The rapid mobilization of intracellular calcium and the generation of cAMP by E2 were demonstrated several decades ago (7,8). More recently, the modulation of potassium currents, phospholipase C activatio...

Estetrol (E4) is a natural estrogen with a long half-life produced only by the human fetal liver during pregnancy. The crystal structures of the estrogen receptor α (ERα) ligand-binding domain bound to 17β-estradiol (E2) and E4 are very similar, as well as their capacity to activate the two activation functions AF-1 and AF-2 and to recruit the coactivator SRC3. In vivo administration of high doses of E4 stimulated uterine gene expression, epithelial proliferation, and prevented atheroma, three recognized nuclear ERα actions. However, E4 failed to promote endothelial NO synthase activation and acceleration of endothelial healing, two processes clearly dependent on membrane-initiated steroid signaling (MISS). Furthermore, E4 antagonized E2 MISS-dependent effects in endothelium but also in MCF-7 breast cancer cell line. This profile of ERα activation by E4, uncoupling nuclear and membrane activation, characterizes E4 as a selective ER modulator which could have medical applications that should now be considered further.