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Only English abstract is available. Basophil testing is the most effective single approach for diagnosing type-IIb autoimmune chronic spontaneous urticaria (TIIbaiCSU). A positive basophil test has been linked to long disease duration, higher disease activity, a poor response to antihistamines and omalizumab, and a better response to cyclosporine and fenebrutinib. As of now it is unclear what other features are connected to a positive basophil test in chronic spontaneous urticaria (CSU). We aimed to identify features of basophil test-positive CSU patients. We performed a cross-sectional study of 85 CSU patients. Basophil testing was done with the basophil activation test (BAT) and the basophil histamine release assay (BHRA). Data were analysed using SPSS: Student’s t-test, Chi-square test, Odds Ratio, Spearman’s correlation test. Of 85 CSU patients, 44% and 28% tested positive with the BAT and BHRA, respectively. These patients showed higher disease activity and impact, lower levels of disease control and total serum IgE, as well as higher rates of having a positive autologous serum skin test (ASST), angioedema, nocturnal symptoms, symptoms for >5 days/week, and thyroid autoantibodies. The ASST, by itself, was not a good predictor of basophil test results, but it predicted a positive basophil test in up to 100% of cases when combined with angioedema, thyroid autoantibodies or low IgE. In conclusion, a positive basophil test is linked to known features of TIIbaiCSU and novel characteristics including nocturnal symptoms. Further studies on basophil test-positive and -negative CSU patients can help to better understand CSU endotypes and to develop better management approaches.

Introdução: A budesonida é um glucocorticoide usado no tratamento de várias patologias, como asma e rinite. As reações de hipersensibilidade à budesonida são pouco frequentes e na sua maioria são reações tardias. Casoclínico: Doente do sexo feminino, 59 anos, iniciou terapêutica inalatória com budesonida 160mcg+formoterol 4,5mcg em contexto de quadro de tosse e pieira recorrente com 6 meses de evolução. Uma semana após o início deste tratamento, apresentou dispneia e ardor orofaríngeo de agravamento progressivo seguido de edema da úvula. Posteriormente, foi encaminhada para a consulta de imunoalergologia. Do estudo realizado, salientam-se testes epicutâneos com a bateria standard do Grupo Português de Dermatites de Contacto positivos para a budesonida (0,1%) e com produtos da doente, apenas positivos para a associação budesonida 160mcg+formoterol 4,5mcg, ambos às 96h. Discussão/Conclusão: Foi, assim, estabelecido o diagnóstico de reação de hipersensibilidade tardia à budesonida inalada, tendo os testes epicutâneos confirmado hipersensibilidade tipo IV. Background: Budesonide is a glucocorticoid used in the treatment of various pathologies such as asthma and rhinitis. Hypersensitivity reactions to budesonide are uncommon and are mostly late reactions. Clinical case: Female patient, 59 years old, started inhaled therapy with budesonide 160mcg + formoterol 4.5mcg in a context of recurrent cough and wheezing with 6 months of evolution. A week after the onset of this treatment, the patient presented with bronchospasm, oropharyngeal burning of progressive aggravation followed by edema of the uvula. Later, she was referred for immunoallergology consultation. From the allergology study, epicutaneous tests with the standard Portuguese Group of Contact Dermatitis were positive for budesonide (0.1%) and tests with patient’s products were positive for budesonide 160mcg + formoterol 4.5mcg, both at 96h. Discussion/Conclusion: The diagnosis of delayed hypersensitivity reaction to inhaled budesonide was established and epicutaneous tests confirmed type IV hypersensitivity.

SPAKE2 is a balanced password-authenticated key exchange (PAKE) protocol, proposed by Abdalla and Pointcheval at CTRSA 2005. Due to its simplicity and efficiency, SPAKE2 is one of the balanced PAKE candidates currently under consideration for standardization by the CFRG, together with SPEKE, CPace, and J-PAKE. In this paper, we show that SPAKE2 achieves perfect forward security in the random-oracle model under the Gap Diffie-Hellman assumption. Unlike prior results, which either did not consider forward security or only proved a weak form of it, our results guarantee the security of the derived keys even for sessions that were created with the active involvement of the attacker, as long as the parties involved in the protocol are not corrupted when these sessions take place. Finally, our proofs also demonstrate that SPAKE2 is flexible with respect to the generation of its global parameters M and N. This includes the cases where M is a uniform group element and M=N or the case where M and N are chosen as the output of a random oracle.