Mukundan, Harshini, Thomas C. Resta, and Nancy L. Kanagy. 17-Estradiol decreases hypoxic induction of erythropoietin gene expression. Am J Physiol Regulatory Integrative Comp Physiol 283: R496-R504, 2002. First published April 4, 2002 10.1152/ajpregu.00573.2001.-Exposure to chronic hypoxia induces erythropoietin (EPO) production to facilitate oxygen delivery to hypoxic tissues. Previous studies from our laboratory found that ovariectomy (OVX) exacerbates the polycythemic response to hypoxia and treatment with 17-estradiol (E2-) inhibits this effect. We hypothesized that E2- decreases EPO gene expression during hypoxia. Because E2- can induce nitric oxide (NO) production and NO can attenuate EPO synthesis, we further hypothesized that E2- inhibition of EPO gene expression is mediated by NO. These hypotheses were tested in OVX catheterized rats treated with E2- (20 g/day) or vehicle for 14 days and exposed to 8 or 12 h of hypoxia (12% O 2) or normoxia. We found that E2- treatment significantly decreased EPO synthesis and gene expression during hypoxia. E2- treatment did not induce endothelial NO synthase (eNOS) expression in the kidney but potentiated hypoxiainduced increases in plasma nitrates. We conclude that E2- decreases hypoxic induction of EPO. However, this effect does not appear to be related to changes in renal eNOS expression. nitric oxide; polycythemia; hypoxia CHRONIC EXPOSURE TO HYPOXIA can cause a number of pathophysiological conditions including pulmonary hypertension and chronic mountain sickness. Hypoxic induction of erythropoiesis leads to polycythemia, which may contribute to the development of these diseases. Erythropoiesis is mediated by the small glycoprotein hormone erythropoietin (EPO; Refs. 3, 12). In adults, EPO is primarily synthesized in the kidney and stimulates red blood cell synthesis in bone marrow. During hypoxia, elevated red blood cell numbers help to compensate for compromised oxygen delivery to tissues.The physiological and biochemical properties of EPO have been extensively studied, but there are few studies to investigate gender differences in regulation of the hormone. It has been demonstrated that 17-estradiol (E2-) can influence the expression of hypoxiainducible genes such as vascular endothelial growth factor and endothelin-1 (ET-1) (4, 11, 58). However, estrogen regulation of EPO gene expression is not well understood. In some tissues such as the uterus and ovaries, E2- has been shown to induce EPO production (34, 67). However, this regulation seems to be independent of pathways involved in hypoxic stimulation of EPO synthesis. In contrast, several investigators have shown that women living at high altitude have a lower hematocrit compared with men at the same altitude. Peschle et al. (40) observed that administration of estrogen benzoate (10 g/day) to ovariectomized (OVX) rats attenuated increases in plasma iron following hypoxia. Studies from our laboratory (46) have also shown that OVX augments hypoxia-induced increases in hematocrit in rats (0.5 atm, ...