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RATIONALE: Chronic spontaneous urticaria (CSU) lesions are characterized by infiltrates of eosinophils and basophils. Studies have suggested a role for the PGD 2 /CRTh2 and eotaxin/CCR3 pathways in eosinophil recruitment to CSU lesions. Eosinophils produce PGD 2 in response to eotaxin, however the effects of PGD 2 on CCR3 expression have not been examined. Therefore, we explored CCR3 and CRTh2 as shared recruitment/activation pathways for eosinophils and basophils. METHODS: We recruited adult CSU subjects (n522) and non-allergic controls (n58). Whole blood was analyzed for baseline CCR3 and CRTh2 expression on basophils and eosinophils by flow cytometry. CCR3 expression was examined in samples stimulated with PGD 2 in the presence or absence of a CRTh2 antagonist (AZD1981). RESULTS: Basophils from CSU subjects exhibited lower CRTh2 and CCR3 at baseline compared to healthy controls (p50.0277 and p50.0001). Eosinophil CRTh2 expression was also significantly lower in CSU subjects compared to controls (p50.0049). CRTh2 and CCR3 were positively correlated on basophils (p50.0157) and eosinophils (p50.0036). Increasing concentrations of PGD 2 reduced eosinophil CCR3 expression to a lesser extent in CSU subjects compared to controls (AUC 521.7 vs 624.6, p<0.0001). AZD1981 inhibited reductions in eosinophil CCR3 induced by PGD 2 (10-6.5 M) in CSU subjects (p50.0001) and healthy subjects (p50.0469). CONCLUSIONS: Reductions in basophil and eosinophil CRTh2 and CCR3 surface expression were positively correlated in CSU subjects. PGD 2 exposure reduced eosinophil CCR3 expression in CSU and healthy subjects which was partially inhibited by CRTh2 antagonism. Further studies examining the coordination of these pathways may provide insights into the observed clinical benefits of CRTh2-targeting in eosinophilic subgroups. 154 Drug-induced urticaria (DIU) and angioedema in Latin American Countries

<b><i>Background:</i></b> Hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) are common. These patients require an effective and safe analgesic alternative. <b><i>Objective:</i></b> The aim of the study was to demonstrate the safety of meloxicam and etoricoxib administered by open oral challenge in 2 equal steps in patients with NSAID hypersensitivity. <b><i>Methods:</i></b> A cross-sectional, descriptive study of patients with a diagnosis of NSAID hypersensitivity who underwent an oral drug provocation test (DPT) with meloxicam or etoricoxib between January 2011 and August 2017 was conducted. The analysis was performed from a database in BD Clinic. <b><i>Results:</i></b> Two hundred and twenty-eight oral provocations were performed with an alternative NSAID (203 with meloxicam and 25 with etoricoxib) in 217 patients with hypersensitivity to NSAIDs. The median age was 38 years. Ninety-eight percent of meloxicam and 100% of etoricoxib DPTs were performed in 2 steps (without previous placebo), and 52% and 64% of meloxicam and etoricoxib DPTs, respectively, were performed with 50% of the therapeutic dose in each step. Tolerance to meloxicam was demonstrated in 192 patients (94.5%) and in 100% of patients receiving etoricoxib. <b><i>Conclusions:</i></b> Open oral provocation with meloxicam and etoricoxib carried out in 2 steps without placebo seems to be safe and implies less costs and less time expenditure. Also, it could be performed with 2 equal doses.