GP174 Allergy–focused history questionnaire and assessment of genotype of polymorphic markerrs182549in theMCM6gene allow to optimize the diet for children with inflammatory bowel diseases

Children with inflammatory bowel disease (IBD) often receive a dairy-free diet during remission period without evidence, which adversely affects their nutritional status. The aim Of the study was to optimize the approaches to prescribing diets for children with IBD Materials and methods 180 children aged 1 to 17 years with IBD (90 patients with Crohn’s disease and 90 – with ulcerative colitis) in clinical remission were included in this study. Testing of Lactase deficiency included Lactose Intolerance quick test (LIQT) and Real-time PCR, using fluorescent TaqMan probes for analyzing the genotype of polymorphic marker rs182549 in the MCM6 gene. Allergy–focused history questionnaire, morphological study of biopsy specimens of the intestine with the counting of eosinophils, dairy products «open food challenge» (with fecal calprotectin assessment) were used for identifying of cow’s milk allergy (CMA). Results According to the results of LIQT: normolactasia (NL) was observed in 26%, moderate hypolactasia (GL) - in 35% and severe GL - in 39% patients with Crohn’s disease. In children with Ulcerative colitis NL was observed in 31,5%, moderate GL - in 32,5% and severe GL - in 36%. In the patients with normolactasia we revealed an increase in the number of genotypes TT of the of the polymorphic marker rs182549 (c.13910 C>T). In patients with moderate and severe GL, the genotype CC of this polymorphic marker was significantly more frequent (P=0.030; OR = 2.72; 95% CI, 1.08–6.87). Dairy products «open food challenge» was performed in 20 children with IBD and suspected CMA (questionnaire score 54–71). CMA was confirmed in 12 patients by the results of the morphological study of intestinal biopsy specimens with the counting of eosinophils and «open food challenge». According to these findings diet recommendation for patient with IBD were personalized: Cow’s milk-free diet - for children with CMA, Lactose-free diet - for children with severe lactose intolerance, Low lactose diet was recommended to the patients with moderate hypolactasia, Diet containing Cow’s milk - for other patients. Children with GL and genotypes TT had better prognosis for lactose-tolerance. Conclusion Allergy–focused history questionnaire for identifying of CMA, Lactose Intolerance quick test and assessment of genotype of polymorphic marker rs182549 in the MCM6 gene may improve approaches for personalization of diet for patients with IBD.