P-056: Buccal epithelial cell chemokine release as a biomarker for clinical response to therapy in inflammatory bowel disease

s of the 3rd International Symposium on Pediatric Inflammatory Bowel Disease S413 1.4±0.21 for patients, respectively. Mean±SD daily physical activity in controls was 1070±296 kCal, whereas patients spent 913±243 kCal. Patients significantly spent more time in sedentary behaviour than controls (88.8±1.1% vs. 83.6±0.8%; p = 0.0003), whereas significantly less time was spent in light and moderate behaviour (8.2±0.7% vs. 11.9±0.6%; p = 0.0003, and 2.9±0.5% vs. 4.3±0.4%; p = 0.0245, respectively). There was no significant difference in vigorous behaviour (0.1±0.03% vs. 0.3±0.09%; p =NS). Conclusion: Although pediatric IBD patients are active over a longer period of time per day, they have significantly reduced physical activity in comparison with healthy controls, with less vigorous activity. These observations can contribute to altered body composition and decreased skeletal mass. P-055 The natural history of pediatric IBD according to the Paris classification J.E. van Limbergen1 *, P. Henderson2, H.E. Drummond2, R.K. Russell3, J. Satsangi2, D.C. Wilson2. 1Dalhousie University, Halifax, Canada, 2University of Edinburgh, Edinburgh, United Kingdom, 3Yorkhill Hospital, Glasgow, United Kingdom Introduction: Paediatric IBD is more dynamic and extensive than adult IBD. Aims: Describe the Paris-phenotype of paediatric IBD, at diagnosis and after 2 & 4 years. Methods: 716 patients [<17 y: A1a (<10 y) and A1b (10 17 y)] were classified according to the Paris classification and need for surgery. Results: A1a CD differs from A1b (p = 0.0002): A1a has less ileal disease (6/154 vs 32/313; p = 0.01) and more oral +/ perianal CD at diagnosis (14/154 vs 3/313; p < 0.0001) and follow-up (p = 0.0007 and p = 0.02 at 2 y and 4 y). By 4 years, A1a CD is less panenteric (4/67 vs 18/103; p = 0.03). Within A1a CD, there is no difference in location between children diagnosed <6 y and 6 y-9 y. A1b CD is more likely than A1a to progress to penetrating behaviour (p < 0.0001). By 2 years, location changed in 59/283: ileal extension was more common (24/59) than colonic (13/59), p = 0.02. 28/59 had upper GI extension. 18/153 of A1a CD required surgical resection compared with 54/312 of A1b CD (p = 0.12). UC presented as pancolitis in 36/60 of A1a vs 77/103 of A1b, p = 0.04. By 4 years, E4 UC was less common in A1a (15/30 vs 20/26, p = 0.03). 14/61 of A1a UC vs 21/108 of A1b UC required colectomy (p = 0.58). Conclusions: A1a CD is characterised by less ileal but more oral +/ perianal disease. A1a CD remains largely inflammatory but A1b CD progresses to penetrating behaviour. Childhood UC is extensive at diagnosis but A1a UC is less often pancolitic than A1b UC. P-056 Buccal epithelial cell chemokine release as a biomarker for clinical response to therapy in inflammatory bowel disease D.A. Winter1 *, C.L. Menckeberg2, H.C. Raatgeep2, L.F. de Ruiter2, C. Bakker2, Y. Simons-Oosterhuis2, L. de Ridder1, J.M. Hulst1, B.A.E. de Koning1, S.D.M. TheunsValks1, S. Veenbergen2, J.C. Escher1, J.N. Samsom2. 1Department of Pediatric Gastroenterology, EMC Sophia Children’s Hospital, Rotterdam, The Netherlands, 2Laboratory of Ped Gastroenterology & Nutrition, EMC Sophia Children’s Hospital, Rotterdam, The Netherlands Introduction: In a previous pilot study we reported that buccal epithelial cells (BEC) of pediatric Crohn’s disease (CD) but not ulcerative colitis (UC) patients or age matched controls, are immunologically active, spontaneously releasing chemokines. Despite achievement of remission with anti-inflammatory drugs, disease can reactivate during maintenance treatment in CD and UC. Methods to detect therapy responsiveness and early disease reactivation are desired. We hypothesize that measuring chemokine release by BEC may constitute a noninvasive method to assess disease activity. Aim: Confirm chemokine CXCL8, CXCL9 and CXCL10 release by BEC in a well-defined cohort of pediatric CD and UC patients. Extend data with measurements before treatment and during follow-up and assess association with therapy responsiveness. Methods: Chemokine concentrations in supernatant of 24hour BEC cultures from children with CD (n = 6) or UC (n = 5) were assessed by cytometric-bead-array. Paired samples were taken before treatment and after induction therapy while on maintenance treatment. Follow-up varied between 3 22 months after start of induction therapy. Results: Before treatment, BEC from CD (100%) and UC (83.3%) patients released at least one chemokine above threshold. Furthermore, before treatment and during follow-up BEC of CD patients released significantly more CXCL10 compared to BEC of UC patients. Of all chemokines, CXCL8 release declined most in all CD and UC patients receiving maintenance treatment. Conclusion: In therapy naive patients BEC activation occurs in CD but can also arise in UC. BEC from CD patients preferentially secrete CXCL10. Preliminary data indicate BEC activity declines after induction therapy while on maintenance treatment. P-057 A nurse-led tertiary adolescent IBD clinic: 12 month trial and exploration of patient satisfaction L. Whitley1, F. Kiparissi2 *, C. Murray2, S. McCartney2. 1University College London hospital, London, United Kingdom, 2UCLH, London, United Kingdom Aim: The incidence of adolescent IBD continues to rise. Our study’s aim was to describe a newly established adolescent IBD nurse clinic and assess patient satisfaction. Methods: Over 12 months adolescents were reviewed by an IBD nurse specialist (CNS). A validated OP patient satisfaction survey was used to measure patient satisfaction over a 2 week period. The survey focused on the family + friend test (Q1), whether questions asked were answered satisfactorily (Q2), confidence/trust in the CNS (Q3), if enough information was given(Q4). Respondents ranked satisfaction on a validated scale. Results: 124 patients, Males n = 63, (13 24 yrs), seen by CNS for general review (28.2%), commencing medication (25%), teaching drug administration (19.3%), blood monitoring (9.7%), psychological support (7.3%), new diagnosis (6.4%), unwell (5.6%), other (1.6%), some patients were seen for multiple reasons.47, Male n = 26, aged <15 years (n = 2), 16 24 years (n = 44), not stated(n = 1). Q1, 68% of patients were extremely likely and 32% likely to recommend clinic to family and friends. 85% felt their questions were fully (64%) or partially (21%) answered. 13% did not ask any questions and 1 felt their questions were not answeredQ3 100% had confidence in the information provided by the IBD CNS Q4 98% thought the right amount was given, 1 patient said too much information was given. Conclusion: Adolescent IBD nurse led clinics are feasible, well accepted, highly valued by patients, provide high quality care, education, teaching and improve access. Our nurse led clinic model shows potential for high quality service delivery in times of financial restrain. by gest on M ay 8, 2016 http://eccoxfordjournals.org/ D ow nladed from