Chemoattractant receptor-homologous molecule expressed on T helper 2 cells (CRTH2) has attracted interest as a potential therapeutic target in inflammatory diseases. Ramatroban, a thromboxane A 2 receptor antagonist with clinical efficacy in allergic rhinitis, was recently found to also display potent CRTH2 antagonistic activity. Here, we present the pharmacological profile of three ramatroban analogs that differ chemically from ramatroban by either a single additional methyl group (TM30642), or an acetic acid instead of a propionic acid side chain (TM30643), or both modifications (TM30089). All three compounds bound to human CRTH2 stably expressed in human embryonic kidney 293 cells with nanomolar affinity. [ 3 H]Prostaglandin D 2 (PGD2) saturation analysis reveals that ramatroban and TM30642 decrease PGD2 affinity, whereas TM30643 and TM30089 exclusively depress ligand binding capacity (B max ). Each of the three compounds acted as potent CRTH2 antagonists, yet the nature of their antagonism differed markedly. In functional assays measuring inhibition of PGD2-mediated 1) guanosine 5Ј-O-(3-thio)triphosphate binding, 2) -arrestin translocation, and 3) shape change of human eosinophils endogenously expressing CRTH2, ramatroban, and TM30642 produced surmountable antagonism and parallel rightward shifts of the PGD2 concentration-response curves. For TM30643 and TM30089, this shift was accompanied by a progressive reduction of maximal response. Binding analyses indicated that the functional insurmountability of TM30643 and TM30089 was probably related to long-lasting CRTH2 inhibition mediated via the orthosteric site of the receptor. A mechanistic understanding of insurmountability of CRTH2 antagonists could be fundamental for development of this novel class of anti-inflammatory drugs.Prostaglandin D 2 (PGD2) is the major prostanoid released by activated mast cells and is implicated as proinflammatory mediator in diseases such as allergic rhinitis, atopic dermatitis, and asthma (Hata and Breyer, 2004). The prime mode of PGD2 action is through two G protein-coupled receptors referred to as DP/DP1 and CRTH2/DP2, respectively (Boie et al., 1995;Hirai et al., 2001). Both PGD2 receptors transduce extracellular signals predominantly by coupling to heterotrimeric G proteins. DP is positively linked to adenylyl cyclases via G␣ s proteins.