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Estrogenic regulation of tissue factor and tissue factor pathway inhibitor in platelets

¹Department of Surgery, ²Department of Biochemistry and Molecular Biology, ³Section of Hematology, and ⁴Department of Physiology and Bioengineering, Mayo Clinic College of Medicine, Rochester, Minnesota

Submitted 22 December 2004 ; accepted in final form 16 June 2005

Oral estrogen treatment increases thrombotic risk. Tissue factor (TF), tissue factor pathway inhibitor (TFPI), and platelet interaction with leukocytes are important determinants of thrombogenesis. Therefore, the present study was designed to define and compare platelet TF and TFPI mRNA and adhesion protein expression in platelets derived from animals treated with different types of oral estrogens. Ovariectomized pigs were treated with 17-estradiol (2 mg/day), conjugated equine estrogen (CEE; 0.625 mg/day), or raloxifene (60 mg/day) for 4 wk. Compared with intact animals, ovariectomy and treatment differentially affected populations of leukocytes: neutrophils decreased whereas lymphocytes increased significantly 4 wk after ovariectomy and with 17-estradiol and CEE treatments; eosinophils increased only with 17-estradiol treatment. Content of TF protein increased in platelets from 17-estradiol- and raloxifene-treated pigs, whereas TF mRNA was detected only in platelets from 17-estradiol- and CEE treated pigs. TFPI mRNA increased in platelets after ovariectomy and estrogen treatment. Only a trace of TFPI protein was detected, but a higher-molecular-mass protein was observed in all treatment groups. Expression of CD40 and CD40 ligand increased with ovariectomy and decreased with 17-estradiol and CEE treatments more than with raloxifene. The ratio of activated to basal P-selectin expression decreased with ovariectomy and increased with raloxifene treatments. These results suggest that estrogenic formulations may affect individual thrombotic risk by different mechanisms that regulate TF and platelet-leukocytic interactions. These studies provide the rationale for evaluation of interactions among platelets and TF and TFPI expression on thrombin generation during estrogen treatment in humans.

conjugated equine estrogen; CD40; 17-estradiol; leukocytes; raloxifene

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