Miller. Differential effects of 17-estradiol, conjugated equine estrogen, and raloxifene on mRNA expression, aggregation, and secretion in platelets. Am J Physiol Heart Circ Physiol 288: H2355-H2362, 2005. First published January 14, 2005 doi:10.1152/ajpheart.01108.2004.-Changes in platelet functions could contribute to thrombotic risk associated with estrogen treatments. This study was designed to test the hypothesis that three clinically relevant estrogenic treatments affect platelet function comparably. Adult female pigs were ovariectomized and randomized to either no treatment or treatment with oral 17-estradiol (2 mg/day), conjugated equine estrogen (0.625 mg/day), or raloxifene (60 mg/day) for 4 wk. Platelet turnover, aggregation, and secretion were assessed before and after treatment. Platelet turnover and mRNA increased significantly only in pigs treated with 17-estradiol. Expression of estrogen receptors increased with ovariectomy and decreased with all treatments. Platelet aggregation and secretion of ATP, platelet-derived growth factor, and matrix metalloproteinase-2 increased with ovariectomy. All treatments reduced both aggregation and secretion. Expression of mRNA for constitutive endothelial nitric oxide synthase (eNOS), but not eNOS protein, increased with ovariectomy. Only eNOS mRNA decreased with all treatments, but only treatment with 17-estradiol increased secretion of nitric oxide from intact platelets. Platelets from 17-estradiol-treated animals caused relaxation of coronary arteries, which was sensitive to inhibition of nitric oxide. Although three different estrogenic treatments reversed increases in platelet aggregation caused by ovariectomy, only 17-estradiol increased platelet RNA and release of plateletderived nitric oxide. These differences reflect transcriptional and posttranscriptional regulation of protein synthesis in bone marrow megakaryocytes and circulating platelets.hormones; matrix metalloproteinase; nitric oxide; thrombosis ESTROGEN TREATMENTS, including selective estrogen receptor modulators (SERMs) like raloxifene, increase risk of venous thrombosis in postmenopausal women (2, 11, 12, 14 -17, 25, 42). In addition, in older women, treatment with conjugated equine estrogen (CEE) but not raloxifene increases arterial thrombotic events such as stroke (41). More information is needed regarding mechanisms by which estrogenic compounds affect thrombosis. Hormones affect the blood vessel wall but also elements of the blood, such as platelets.Platelets contribute to thrombosis in several ways. They provide the membrane surface for the generation of thrombin, express membrane receptors that affect platelet-platelet and platelet-vessel wall interactions, and release vasoactive substances affecting vascular tone, which in turn affect retention of a platelet plug. Platelets and their precursors, megakaryocytes, contain both estrogen receptor (ER)␣ and ER (21,22,26,40). Therefore, the concentration of circulating hormones, i.e., hormonal status defined by the loss or replaceme...