Higher Levels of Exhaled Dimethylcyclopropane in Patients with Small Intestinal Bowel Overgrowth, Periodontitis when Associated with a Medical History of Cancer

Background: Periodontitis (PO) is associated with an increased risk of cancer. Breath test is routinely used for detection of Small Intestinal Bowel Overgrowth (SIBO). Specific Volatile Organic Compounds (VOC) may firstly enable early non-invasive detection of cancers and secondly be markers of specific bacteria. Objective: We investigated whether patients with PO and a medical history of cancer exhale specific gases. Methods: A retrospective epidemiological study was performed based on data from 3, 110 patients with SIBO; including 453 with PO, 208 with a medical history of cancer and 33 with PO+SIBO+cancer. The study retrieved 65 well-documented case reports of patients with PO plus SIBO, including twelve patients who had a medical history of cancer (group 1) and 53 patients who never experienced cancer (group 2). For these 65 patients, VOC were routinely detected by SPME-GC-SM after 10 to 12 hours of fasting (T0) and two hours after the intake of sugar (T2 h). Hyaluronic acid (HA) concentration in plasma (which could be a marker of severe chronic inflammation) was also routinely measured. Data on Helicobacter pylori and on Herpes Simplex infection were available. Results: The ratio dimethylcyclopropane/(Toluene+Phenol+1.3-pentadiene+1-propanol) [DMCP/TPPP] at T0 enables to differentiate between group 1 and group 2 (0.50 ppm ± 0.26 versus 0.28 ± 0.17; p<0.01). The difference between [DMCP/TPPP] at T0 and at T2 h is also statistically significant (0.15 ppm ± 0.21in group 1 versus -0.07 ± 0.20 in group 2; p<0.001). HA was higher in group 1 (78.3 ± 40.5 microg/l versus 37.7 ± 19.6; p<0.001). Conclusion: DMCP/TPPP and HA level may be interesting markers for cancer screening in at risk patients. An implication of Campylobacter species should be further investigated.