Prostaglandin E 2 (PGE 2 ) plays a key role in the ductus arteriosus, prenatally by maintaining patency and postnatally by promoting tissue remodeling for closure. Here, by using near-term mouse fetuses with (wild-type, WT) and without microsomal PGE synthase-1 (mPGES1Ϫ/Ϫ), we have examined the importance of this enzyme for PGE 2 formation and function. mPGES1Ϫ/Ϫ ductus, unlike WT ductus, contracted little, or not all, to indomethacin in vitro. Coincidentally, as evident from responses to N G -nitro-Larginine methyl ester and zinc photoporphyrin, the mutant showed no significant enhancement of nitric oxide (NO)-and carbon monoxide (CO)-based relaxation. mPGES1 suppression differs, therefore, from cyclooxygenase (COX) suppression, whether genetically or pharmacologically induced, where NO is markedly up-regulated. In vivo, the ductus was patent, albeit occasionally with a narrowed lumen, in all mPGES1Ϫ/Ϫ fetuses. Conversely, postnatal closure progressed regularly in mPGES1Ϫ/Ϫ animals thanks to residual PGE 2 originating via mPGES2. We conclude that mPGES1 is critical for PGE 2 formation in the ductus but its loss does not entail compensatory upregulation of other relaxing mechanisms. Accordingly, an mPGES1 inhibitor stands out as a prospective better tool, compared with the currently used COX inhibitors, for the management of premature infants with persistent ductus. (Pediatr Res 64: 523-527, 2008) P rostaglandin (PG) E 2 is viewed as the prime agent for prenatal patency of the ductus arteriosus (1). Conversely, PGI 2 is without a role, notwithstanding its occurrence in the vessel and its known importance for vasoregulation elsewhere (2,3). Ductal PGE 2 is formed primarily through the cyclooxygenase-2 (COX2)/microsomal PGE synthase-1 (mPGES1) complex, while little of the compound originates from the COX1/mPGES1 complex and none at all from cytosolic PGES (cPGES). No information is available on microsomal PGE synthase-2 (mPGES2), but evidence from other vascular districts points to its minor function (4). Several findings support this arrangement in the ductus, namely, immunocytochemical data showing a predominant colocalization of COX2 with mPGES1 (5); the increase in COX2 and mPGES1 expression occurring selectively through development (6); the constrictor action of COX2 inhibitors on the ductus, being close or even equal in magnitude to that of a dual COX1/ COX2 inhibitor (7-9); the greater impairment of PGE 2 -based relaxation upon COX2 than COX1 deletion (5) along with the marked curtailment of PGE 2 formation after inhibition of either COX2 or mPGES1 (6,7). Consistent with the preferential operation of the COX2/mPGES1 route for PGE 2 synthesis is also evidence from adult blood vessels (10) and the notion that mPGES1 is catalytically most active among the PGES (11).Despite these facts, previous attempts to prove the actual importance of the COX2/mPGES1 pathway for ductus patency have failed. As shown by others and ourselves (5,12,13), COX2 removal does not result in loss of patency, likely thanks to ...