Ongoing CMV Infection (qPCR+), Nodular Thyroiditis and Periodontitis are Associated with Ileal Distension (Ileal Brake), Cancer and Increased Plasmatic Hyaluronic Acid Levels

Background: Periodontitis (PO) and Nodular Thyroiditis (NT) are associated with CMV infection and metabolic syndrome, and an increased risk of polyps or colorectal cancer. Objective: We investigated whether oral CMV replication is more frequent in patients with PO+NT and with a medical history of cancer or overweight. Methods: All data were collected during routine consultations for Small Intestinal Bowel Overgrowth (SIBO).CMV IgG serology, CMV DNA (qPCR) in saliva, plasmatic Hyaluronic Acid (HA) dosage, transabdominal and thyroid ultrasound examinations were routinely performed in SIBO. Results: 196 patients were included. 70 patients presented with NT, 59 with PO, 32 patients with NT+PO. 26 patients have CMV DNA in their saliva (13.3%). 12 patients had a medical history of cancer. Patients without NT (116 patients) and without ongoing CMV replication (110) presented with low percentages of cancer, ileal brake or low plasmatic HA levels i.e., 3%, 22% and 43 ± 42 µg/l respectively. Patients (16) with ongoing CMV replication have increased rates of cancer (6%; p<0.01) and of ileal brake (50%; p<0.001). Patients without PO and without ongoing CMV replication (119 patients) presented with low percentage of cancer, ileal brake or low plasmatic HA levels: respectively 3%, 19%, 41.5 ± 40 µg/l. Patients (18) with ongoing CMV replication have increased rates of cancer (11%; p<0.001) and of ileal brake (39%; p<0.001). Patients (6) with NT+periodontitis and with ongoing CMV infection experienced more frequently cancer (50%) or ileal brake (80%) than those (27) without ongoing CMV infection: respectively 11% (p<0.001) and 37% (p<0.05). The level of HA was also higher in patients with qPCR+ (98 ± 50 versus 56 ± 40; p<0.05). Conclusion: Oral active CMV infection appears to be associated with severe tissue destruction, ileal brake/overweight and medical history of cancer.