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A 24 ns biased molecular dynamics simulation was performed with two collective variables: the distance between the oxygen of OH • and Gly.OT1 atom (d (OT1 – OH • ) and distance between the oxygen of OH • and Cys.SG atom (d (SG – OH • )

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457 Gastroenterology & Nutrition Satisfactory Switch to Infliximab after Adalimumab Loss of Response in a Teenager with Severe Crohn`s Disease Andreia Florina Nita 1,2 , Gabriel Becheanu 2,3 , Daniela Pacurar 1,2 1 Paediatrics, Grigore Alexandrescu Emergency Hospital for Children, Romania 2 Paediatrics, Carol Davila University of Medicine and Pharmacy, Romania 3 Histopathology, Victor Babes Clinical Hospital for Infectious and Tropical Diseases, Romania Introduction: Paediatric inflammatory bowel disease is often more aggressive compared to adults and the current tendency is early use of monoclonal antibodies in severe cases, loss of response being the therapeutic challenge