title: Plasma Prostaglandin E2 Levels Correlated with the Prevention of Intravenous Immunoglobulin Resistance and Coronary Artery Lesions Formation via CD40L in Kawasaki Disease.
abstract: BACKGROUND
  A form of systemic vasculitis, Kawasaki disease (KD) occurs most frequently in children under the age of five years old. Previous studies have found that Prostaglandin E2 (PGE2) correlates with KD, although the related mechanisms are still unknown. CD40L may also be a marker of vasculitis in KD, so this study focuses on PGE2 and CD40L expression in KD.
  
  
  METHODS
  This study consisted of a total of 144 KD patients, whose intravenous immunoglobulin (IVIG)/coronary arterial lesion (CAL) formation resistance was evaluated. PGE2 levels were evaluated in vitro to study the effect of CD40L on CD4+ T lymphocytes.
  
  
  RESULTS
  PGE2 levels significantly increased after IVIG treatment (p<0.05), especially in patients who responded to initial IVIG treatment (p = 0.004) and for patients without CAL formation (p = 0.016). Furthermore, an in vitro study revealed that IVIG acted as a trigger for PGE2 expression in the acute-stage mononuclear cells of KD patients. According to our findings, both IVIG and PGE2 can impede surface CD40L expressions on CD4+ T lymphocytes (p<0.05).
  
  
  CONCLUSIONS
  The results of this study are among the first to find that plasma PGE2 is correlated with the prevention of IVIG resistance and CAL formation through CD40L in KD.
authors.affiliation: Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.|Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Ho-Chang
authors.initials: HC
authors.lastname: Kuo
authors.affiliation: Department of Pediatrics, Po-Jen Hospital, Kaohsiung, Taiwan.
authors.forename: Chih-Lu
authors.initials: CL
authors.lastname: Wang
authors.affiliation: Institute of Biomedical Sciences, Mackay Medical School and Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Kuender D
authors.initials: KD
authors.lastname: Yang
authors.affiliation: Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.|Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Mao-Hung
authors.initials: MH
authors.lastname: Lo
authors.affiliation: Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.|Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Kai-Sheng
authors.initials: KS
authors.lastname: Hsieh
authors.affiliation: Genomics and Proteomics Core Laboratory, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Sung-Chou
authors.initials: SC
authors.lastname: Li
authors.affiliation: Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.|Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Ying-Hsien
authors.identifier: http://orcid.org/0000-0002-7127-0046
authors.initials: YH
authors.lastname: Huang
mesh_terms: D015415:Biomarkers / Q000097:blood; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects; D023201:CD40 Ligand / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000150:complications* / Q000517:prevention & control*; D015232:Dinoprostone / Q000097:blood*; D004351:Drug Resistance; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000494:pharmacology*; D007223:Infant; D009080:Mucocutaneous Lymph Node Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D016756:Immunoglobulins, Intravenous; D023201:CD40 Ligand; D015232:Dinoprostone