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

  Donatini Bruno1*      Brunissen Fanny2      Pereira Jeremy2      Grandchamp Mathilde2      Flourat Amandine2      Florent Allais2      Le Blaye Isabelle1   

1Medecine Information Formation (Research), Cormontreuil, France
2Chaire Agro-Biotechnologies Industrielles (ABI); Agro Paris Tech, CEBB, Pomacle, France

*Corresponding author: Donatini Bruno, Medecine Information Formation (Research), 40 rue du Dr Roux, 51350 Cormontreuil, France, Tel: 06-08- 58-46-29; E-mail:


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.


Dimethylcyclopropane; Hyaluronic; Periodontitis; Cancer


Periodontitis (PO) concerns more than 10% of the population [1] and is associated with an increased risk of cancer [2,3]. Chronic inflammation induced by oral or small gut dysbiosis may lead to deleterious interactome and premature death [4,5].

Detection of Small Intestinal Bowel Overgrowth (SIBO) is based on breath test, which should be routinely performed “in the evaluation of common gastroenterology problems” according to a recent consensus [6]. Researchers are ongoing for early non-invasive detection of cancers using exhaled VOC; especially digestive, breast, thyroid and prostatic cancers [7-12].

The pathogenic mechanism of severe inflammation, destruction of tissues associated with PO is unknown. However, the cutting of High-Molecular-Weight-Hyaluronic acid in small fragments of LowMolecular-Weight-Hyaluronic acid (LMWHA) by bacterial proteases is established in PO [13]. We reported in a preliminary study that the severity of PO is associated with an increased level of plasmatic HA and with an increased risk of adenocarcinoma [14].

LMW-HA is known to increase endothelial permeability, to stimulate receptors of cancer stem cells and to favour cancer cells metastasis [15-18]. Hyaluronidases of oral pathogens may play a role in the occurrence of cancer associated with PO. Since bacteria may have a specific gas signature [19], we investigated whether patients with SIBO+PO and severe-associated diseases exhale specific gas. To our knowledge, no similar study has been performed yet.

Material and Methods

All data were collected during the normal course of routine gastroenterological consultations for SIBO.

There was no hypothesis testing before data collection, no data collection beyond that which is part of routine clinical practice, no scheduled data analysis before the work has already been done. This epidemiological retrospective analysis of Case Series cannot therefore be qualify as “research” and does not requires approval from ethics boards designed to protect humans involved in clinical research, according to the International Committee of Medical Journal Editors (ICMJE).

Inclusion criteria

All patients underwent a breath test and a trans abdominal ultrasound which confirmed SIBO. Patients did not take either antibiotic therapy or any medication which can modify digestive flow for at least 4 months before the breath test.

Patients presented with PO diagnosed by a periodontologist. Patients should have completed an appropriate screening for cancer (colon, stomach, breast, prostate, thyroid) according to the recommendations of the “Institute National du Cancer “(France). Plasmatic hyaluronic acid (HA) dosage had been performed. A full medical history was available, including medication intake. Patients signed a written consent for the epidemiological use of collected data; as all other patients consulting in the gastroenterological clinic.

Exclusion criteria

Ongoing tobacco abuse; lack of hyaluronic acid analysis; lack of breath test or trans abdominal ultrasound; lack of signed consent for epidemiological use of data. Intake of antibiotic therapy or of any medication which may modify digestive flow as well as surgical treatment of periodontitis within the previous 4 months.

Gases analysis

The measurement of VOC implies SPME-GC-MS with collection of gases on a PDMS/CAR, 75 µm (Supelco®) fibres chosen to trap VOCs. The patient breathes in a glass bottle with no plastic part. Condensates remain in the bottom of the bottle whilst the air is evacuated by 8mm glass tube which contains the fibre. Samples were obtained twice after fasting and twice two hours after the intake of sugars (fructose and trehalose). The air of the clinic is permanently Hepa-filtered and UVdecontaminated. Lack of any VOC contamination is checked twice each working-day with two different MX6® devices (Gazdetect® France). SPME-GC-SM analysis was performed within 24 hours. A solid phase micro extraction (SPME) holder with carboxen/polydimethylsiloxane (CAR/PDMS) fibers of 75 µm thickness was purchased from Supelco® . The SPME fiber was inserted into the glass bottle where the patients blew 10 times to collect the sample.

The analysis was performed on a GC-MS instrument (Agilent® GC 7890A/MS 5975C) equipped with a Rxi 624 Sil column (length 60m × inner diameter 250 µm × film thickness 0.25 µm) (Restek®). VOC identification was realized with mass spectra bank. Peak areas corresponding to m/z of each molecule were estimated in Areas Arbitrary Unit (AAU). The values for relative polarity are normalized according to Reichardt C, et al.

Relevant gases were selected according to previous publications on VOC in human breath. Acetonitrile, dichloromethane, ethylacetate, phenylethanol, M-xylene, 2-propanol and P-cymene were considered as environmental contaminants [19,20].

With our method which did not take into consideration the breath flow because of ambulatory easy-to-use equipment-the measurement of ethanol in breath was not considered to be reliable [21]. Acetone is reported to be a potential marker in clinical practice [22]. 2-methylbutane (isopentane) may be found in human breath [23]. 1,3 pentadiene can be produced by fungus belonging to human gut microbiota [24]. Dimethylcyclopropane (DMCP) is a well-known byproduct of gut microbiota [25]. 1-propanol is relevant to measure the impact of fasting [26] or in lung cancer [27]. Toluene is a well-known interesting gas for detection of severe human diseases [28]. High yield of various phenols are produced by gut bacteria [29]. These gases are therefore selected for statistical analysis.


The first group includes patients with SIBO, PO and a medical history of cancer. The second group includes patients with SIBO+PO without a medical history of cancer. In order to avoid large interindividual fluctuations, gases with limited changes between T0 and T2 h were identified and ratios were calculated using VOCs with broad magnitude (broad VOC) as numerator and VOCs with mild magnitude (low VOC) as denominator. The following gazes were detected by the SPME-GC-SM analysis: ethanol, acetonitrile, dichloromethane, ethylacetate, phenylethanol, M-xylene, 2-propanol, P-cymene, acetone, 2-methylbutane (isopentane), 1,3 pentadiene, dimethylcyclopropane, 1-propanol, toluene and phenol. Only acetone, 2-methylbutane (isopentane), 1,3 pentadiene, dimethylcyclopropane, 1-propanol, toluene and phenol were further analysed.

Gases were split into two groups. The first group includes gazes with broad (broad VOC) inter-individual fluctuation at T0 or at T2 hours (standard deviation>2 means): 2-methylbutane (157,907 ± 415,878), dimethylcyclopropane (85,839 ± 307,163) and acetone (569,139 ± 1,673,014). The second group of gazes includes gazes with low (low VOC) inter-individual fluctuations at T0 or T2 hours: 1,3 pentadiene (60,356 ± 75,821), 1-propanol (10,147 ± 17,364), toluene (55,297 ± 65,925) and phenol (58,617 ± 98,145).

Ratios of broad VOC/low VOC were compared between group 1 and group 2. (Comparison of means) Calculations were performed for T0 , for T2 and for differences between T0 and T2 . Comparisons of means were performed using independent samples T tests. Since the number of patients in group1 is below 30, a Student-Fisher T-test was chosen. Specificity, false positive ratio, negative predictive value and positive predictive value and ROC curve were calculated for relevant parameters (D/TPPP).


65 patients were included: 12 in group 1 (Table 1) and 53 in group 2 (Table 2). Mean of broad VOCs/low VOCs ratios were compared between group1 and group 2 (Table 3).

  Patients Clinical Herpes simplex Plasmatic Hyaluronic acid (µg/l) Helicobacterpylori   Diseases
1 Yes 105 Yes Thyroid cancer
2 Yes 75 No Colonic cancer
3 Yes 32 Yes Colonic cancer
4 Yes 58 Yes Prostatic cancer
5 Yes 109 Yes Breast cancer
6 Yes 78 No Carcinoma of the uterine cervix
  7   Yes   68   No Thyroid cancer, carcinoma of the uterine cervix
8 No 35 No Thyroid carcinoma
9 Yes 171 No Prostatic cancer
10 Yes 89 Yes Colonic cancer
11 No 25 No Giant cell tumour of the knee
12 No 95 No Thyroid cancer
Mean or
9 78.3 5  
SD or % 75% 40.5 41.7%  

Table 1: Patients with SIBO+PO and cancer (group 1; 12 patients).
Patients with SIBO (Small Intestinal Bowel Overgrowth) + PO (Periodontitis) + medical history of cancer (mainly adenocarcinoma). Hyaluronic acid levels are high; almost twice the normal range (40 µg/l).

Patients Clinical herpes simplex Plasmatic Hyaluronic acid (µg/l) Helicobacterpylori Diseases
1 No 58 Yes Severe metabolic syndrome (myocardial infarctions, NASH)
2 No 95 No Severe metabolic syndrome (diabetes, NASH)
3 No 12 Yes Parkinson’s disease, psoriasis, thyroiditis
4 No 50 No Severe metabolic syndrome (diabetes, NASH)
5 Yes 26 No NASH
6 Yes 34 Yes Helicobacter pylori
7 Yes 12 No Esophagitis
8 No 65 Yes Thyroiditis
9 Yes 16 No Urticaria, eczema, herpes, alcohol
10 No 18 Yes Untreated dental cavities, oral aphtous lesions
11 Yes 35 No Mild COPD, eczema
12 No 37 Yes Thyroiditis, eczema
13 No 50 No Colonic diverticulosis
14 No 71 Yes Toxic extrapyramidal disorder
15 Yes 30 Yes Overweight
16 Yes 48 Yes Osteoporosis, gastro duodenal ulcer
17 Yes 65 Yes Mild liver steatosis, severe acne
18 No 25 Yes Vitiligo, allergy
19 No 22 No Zona, alcohol
20 No 42 Yes Severeacne (isotretinoin), psoriasis
21 Yes 19 No Thyroiditis
22 No 35 Yes Fibromyalgia, psoriasis
23 No 12 No Diverticulosis, thyroiditis
24 Yes 28 Yes Psoriasis, furonculosis
25 Yes 50 No Controlled HIV, urticaria
26 Yes 19 No Severe herpes, migraine
27 Yes 45 Yes Overweight, psoriasis,acne, oral aphtous lesions
28 No 12 Yes Vitiligo
29 No 56 Yes Overweight, endometriosis, chronic rhinosinusitis.
30 No 26 No Gougerot-Sjögren, atrophicthyroiditis, osteoporosis
31 No 12 Yes Severe acne (isotretinoin), chronic rhinosinusitis
32 No 33 No Controlled metabolic syndrome, no NASH
33 No 17 No Psoriasis
34 Yes 36 No Overweight, liver steatosis, no NASH
35 No 74 Yes Thyroiditis
36 Yes 46 Yes Liver steatosis, no NASH, mild psoriasis
37 Yes 39 No Atrophic thyroiditis, pollen allergy
38 Yes 65 No Eczema, osteopenia
39 Yes 14 Yes Acne, nasal polyps
40 No 45 Yes Asthma, steatorrhea
41 Yes 51 No Diarrhea
42 No 12 No Pollen allergy, overweight, liver steatosis
43 No 48 No Asthenia, acne
44 No 33 No Obesity, cardiac arrhythmia, glucose intolerance
45 No 48 Yes Dysbiosis, abdominal pain
46 Yes 49 Yes Mild psoriasis
47 No 38 No Osteopenia, controlled Hashimoto’s thyroiditis
48 No 9 Yes Depression, liver steatosis
49 No 24 No Liver steatosis, pollen allergy
50 Yes 56 No Asthenia, mild depression
51 Yes 30 Yes Eczema, severe gastro-oesophageal reflux
52 Yes 34 Yes Urticaria, chronic rhinosinusitis
53 Yes 72 No Dysbiosis, bloating, abdominal pain
Mean or
24 37.7 26
SD or % 45.3 19.6 49.1

Table 2: Patients with SIBO+PO, without cancer (group 2; 53 patients).
Patients with SIBO (Small Intestinal Bowel Overgrowth)+PO (Periodontitis) and no medical history of cancer. Hyaluronic acid levels are less than 40 µg/l.

  Group 1
(12 patients)
Group 2
(53 patients)
P values
M 0.82 ± 0.64 0.60 ± 0.57 > 0.05
D 0.50 ± 0.26 0.28 ± 0.17 <0.01
A 3.48 ± 3.46 2.26 ± 2.20 >0.05
M+D 1.24 ± 0.85 0.87 ± 0.69 > 0.05
D+A 3.91 ± 3.58 2.53 ± 2.25 >0.05
M+A 4.30 ± 3.95 2.86 ± 2.52 >0.05
M+D+A 4.73 ± 4.07 3.13 ± 2.59 >0.05
T2 hours      
M 0.89 ± 0.87 0.73 ± 0.71 >0.05
D 0.34 ± 0.20 0.38 ± 0.24 >0.05
A 2.82 ± 2.61 1.9 ± 1.29 >0.05
M+D 1.22 ± 1.05 1.06 ± 0.90 >0.05
D+A 3.15 ± 2.73 2.23 ± 1.47 >0.05
M+A 3.71 ± 3.14 2.62 ± 1.75 >0.05
M+D+A 4.04 ± 3.28 2.95 ± 1.95 >0.05
T0-T2 hours      
M -0.07 ± 0.23 -0.13 ± 0.14 >0.05
D 0.15 ± 0.21 -0.07 ± 0.20 <0.001
A 0.66 ± 0.85 0.37 ± 0.91 >0.05
M+D 0.02 ± 0.20 -0.19 ± 0.22 <0.01
D+A 0.76 ± 0.84 0.30 ± 0.78 >0.05
M+A 0.59 ± 0.81 0.24 ± 0.77 >0.05
M+D+A 0.69 ± 0.79 0.17 ± 0.65 >0.05

Table 3: Comparison of ratios M/TPPP, D/TPPP, A/TPPP, (M+D)/TPPP, (D+A)/TPPP and (M+D+A)/TPPP between group 1 and group 2.

The most reliable ratios to differentiate the 12 groups were dimethylcyclopentane/(toluene+phenol+1propanolol+pentadiene) (D/TPPP) either for T0 (0.50 ± 0.26 versus 0.28 ± 0.17; p<0.01) or for the difference between T0 and T2 (0.15 ± 0.21 versus -0.07 ± 0.20; p<0.001).

All 65 patients were classified according to the ratio D/TPPP. The sensitivity and the false positive rate were calculated. The figure 1 shows the ROC curve for the ratio D/TPPP. The threshold is close to 0. The sensitivity is equal to 75% and the false positive rate is equal to 31.25%. The negative predictive value is equal to 91.7% and the positive predictive value is equal to 96.4%. Patients in group1 had a higher plasmatic concentration of HA (78.3 ± 40.5 microg/l versus 37.7 ± 19.6; p<0.001). Patients in groups 1or 2 have high and similar percentage of infection with Helicobacter pylori (HP) (respectively 41.7% and 49.1%; p<0.05) or of clinical herpes simplex (58.8% versus 48%, p<0.05).

Figure 1: ROC curve for the D/TPPP ratio.
The threshold between group 1 (medical history of cancer) and group 2 (no medical history of cancer) is close to 0. The sensitivity is equal to 75% and the false positive rate is equal to 31.25%. The negative predictive value is equal to 91.7% and the positive predictive value is equal to 96.4%. The values are satisfactory (AUC=0.814), as far as simple screening is concerned.

Discussion and Conclusion
Concerning VOC detection

PO has been attributed to specific types of bacteria [30,31] and is associated with an increased risk of cancers [2,3].

Bacterial signature may be identified by breath tests focused on VOC [32-35]. Early detection of some cancers may also be detected by exhaled VOC [7-12].

In this epidemiological retrospective analysis, the ratio of DMCP/ TPPP was higher in patients with a medical history of cancer (p<0.001). The sensitivity (75%), the false positive rate (31.25%), the negative predictive value (91.7%) and the positive predictive value (96.4%) of the ratio D/TPPP are satisfactory, as far as simple screening is concerned. This is the first time that a link between DMCP and a medical history of cancer is reported.

DMCP is derived from cyclopropane ring which occurs only in organisms that synthesize specific unsaturated fatty acids (UFA). Cyclopropane Fatty Acids (CFA) are typically produced at the onset of the stationary phase in bacterial cultures [36]. The timing and extent of the UFA-to-CFA conversion and the widespread distribution of CFA synthesis among bacteria suggest an important physiological role for this phenomenon [25,36].

The following bacteria may produce CFA: i.e. Arthrobacter, Alcaligenes, Azotobacter, Bifidobacterium, Bordetella, Campylobacter, Caulobacter, Clostridium, Chlorobium, Citrobacter, Enterobacter, Helicobacter, Klebsiella, Lactobacillus, Nitrobacter, Pediococcus, Proteus, Pseudomonas, Rhizobium, Salmonella, Serratia, Streptococcus, Thiobacillus, Vibrio, Yersinia [25].

Some bacteria can be excluded since there are mainly found in soil, used in food processing or are opportunistic bacteria which develop only in severely immunosuppressed patients: Arthrobacter, Alcaligenes, Azotobacter, Bifidobacterium, Citrobacter, Lactobacillus, Nitrobacter, Pediococcus, Rhizobium, Serratia or Thiobacillus. Other bacteria can also be excluded since they induce severe acute infections and since the included patients did not have any acute infection when enrolled: i.e. Bordetella,Salmonella, Vibrio, and Yersinia.

Some bacteria are either commensal or induce acute infections or intoxications. There implication in chronic infections has never been documented: i.e. Clostridium, Enterobacter, Klebsiella, Proteus, Pseudomonas or Streptococcus [37].

Campylobacter or Helicobacter are the only remaining possible candidates.

Numerous publications have causally implicated HP or Campylobacters [38,39], in the occurrence of PO. HP synthetizes 19:0 cyclopropane [40].

97% of Campylobacter jejuni strains and 83% of Campylobacter coli strains are characterized by the presence of a 19-carbon cyclopropane fatty acid. Others Campylobacters (including Campylobacter rectus) lack 19-carbon cyclopropane [41,42].

Because the percentage of HP is similar between the two groups of patients, we hypothesize that Campylobacter jejuni or Campylobacter coli could explain the higher rate of dimethylcyclopropane in patients with a medical history of cancer.

Concerning hyaluronic acid levels

Patients in group1 have a higher plasmatic concentration of HA (78.3 ± 40.5 microg/l versus 37.7 ± 19.6; p<0.001). We reported in a preliminary study that an increased level of plasmatic HA is associated with an increased risk of adenocarcinoma in patients with severe PO [14].

Hyaluronidase activity has not been described either for Campylobacter jejunior for Helicobacter pylori. However, some strains of Campylobacter jejuni synthetize a hyaluronic acid-type capsular polysaccharide [43,44], which may modify the level of circulating HA.

Campylobacter jejuni is associated with SIBO and small gut motility decrease [45-46]. However, this bacterium has not yet been implicated in the occurrence of adenocarcinoma. [47,48]. To our knowledge Campylobacter jejuni has not been associated with PO.

Campylobacter rectus is associated with PO [30,31] and total cancer risk increase [48]. Since all Campylobacters may N-glycosylate their proteins [49], an involvement of Campylobacter rectus in the increase of plasmatic HA cannot be excluded. However, this latter bacterium does not produce dimethylcyclopropane.

To conclude, in patients with SIBO+PO and a medical history of cancer, plasmatic hyaluronic acid level is increased as well as exhaled dimethylcyclopropane concentration. The measure of VOC (especially DMCP) and of plasmatic hyaluronic acid level on a routine basis in patients with SIBO and PO could help to detect patients with a higher risk of cancer. The implication of Campylobacter jejuni or of Campylobacter rectus should be further investigated.

Acknowledgment(S) and Conflicts of Interest

No conflict of interest to disclose.


  1. Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, et al. (2017) Global epidemiology of dental caries and severe periodontitis-a comprehensive review. J Clin Periodontol 44: S94-S105. [Ref.]
  2. Michaud DS, Kelsey KT, Papathanasiou E, Genco CA, Giovannucci E (2016) Periodontal disease and risk of all cancers among male never smokers: an updated analysis of the Health Professionals Follow-up Study. Ann Oncol 27: 941-947. [Ref.]
  3. Momen-Heravi F, Babic A, Tworoger SS, Zhang L, Wu K, et al. (2017) Periodontal disease, tooth loss and colorectal cancer risk: Results from the Nurses’ Health Study. Int J Cancer 140: 646-652. [Ref.]
  4. Söder B, Jin LJ, Klinge B, Söder PO (2007) Periodontitis and premature death: a 16-year longitudinal study in a Swedish urban population. J Periodontal Res 42: 361-366. [Ref.]
  5. Carter CJ, France J, Crean S, Singhrao SK (2017) The Porphyromonas gingivalis/Host Interactome Shows Enrichment in GWASdb Genes Related to Alzheimer’s Disease, Diabetes and Cardiovascular Diseases. Front Aging Neurosci 9: 408. [Ref.]
  6. Rezaie A, Buresi M, Lembo A, Lin H, McCallum R, et al. (2017) Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus. Am J Gastroenterol 112: 775-784. [Ref.]
  7. Durán-Acevedo CM, Jaimes-Mogollón AL, Gualdrón-Guerrero OE, Welearegay TG, Martinez-Marín JD, et al. (2018) Exhaled breath analysis for gastric cancer diagnosis in Colombian patients. Oncotarget 9: 28805-28817. [Ref.]
  8. Markar SR, Wiggins T, Antonowicz S, Chin ST, Romano A, et al. (2018) Assessment of a Noninvasive Exhaled Breath Test for the Diagnosis of Oesophagogastric Cancer. JAMA Oncol 4: 970-976. [Ref.]
  9. Phillips M, Cataneo RN, Cruz-Ramos JA, Huston J, Ornelas O, et al. (2018) Prediction of breast cancer risk with volatile biomarkers in breath. Breast Cancer Res Treat 170: 343-350. [Ref.]
  10. Guo L, Wang C, Chi C, Wang X, Liu S, et al. (2015) Exhaled breath volatile biomarker analysis for thyroid cancer. Transl Res 166: 188- 195. [Ref.]
  11. Kabir KMM, Donald WA (2018) Cancer breath testing: a patent review. Expert Opin Ther Pat 28: 227-239.
  12. Peng G, Hakim M, Broza YY, Billan S, Abdah-Bortnyak R, et al. (2010) Detection of lung, breast, colorectal, and prostate cancers from exhaled breath using a single array of nanosensors. Br J Cancer 103: 542-551. [Ref.]
  13. Utoh E, Okazaki J, Gonda Y (1998) Analysis of hyaluronic acid in human gingival crevicular fluid using high-performance liquid chromatography. J Osaka Dent Univ 32: 1-7. [Ref.]
  14. Donatini B, Le Blaye I (2018) Patients with Hashimoto Thyroiditis (HT) plus Periodontitis (PO) have a more frequent destruction of hyaluronic acid (HA) and medical history of adenocarcinoma (AC). Oral presentation. Proceedings of the 11th Congress of Autoimmunity 16-20.
  15. Singleton PA (2014) Hyaluronan regulation of endothelial barrier function in cancer. Adv Cancer Res 123: 191-209. [Ref.]
  16. Petrey AC, de la Motte CA (2014) Hyaluronan, a crucial regulator of inflammation. Front Immunol 5: 101. [Ref.]
  17. Zlobec I, Terracciano L, Tornillo L, Günthert U, Vuong T, et al. (2008) Role of RHAMM within the hierarchy of well-established prognostic factors in colorectal cancer. Gut 57: 1413-1419.
  18. Wu RL, Huang L , Zhao HC, Geng XP (2017) Hyaluronic acid in digestive cancers. J Cancer Res Clin Oncol 143: 1-16. [Ref.]
  19. Amann A, Costello Bde L, Miekisch W, Schubert J, Buszewski B, et al. (2014) The human volatilome: volatile organic compounds (VOCs) in exhaled breath, skin emanations, urine, feces and saliva. J Breath Res 8: 034001. [Ref.]
  20. de Lacy Costello B, Amann A, Al-Kateb H, Flynn C, Filipiak W, et al. (2014) A review of the volatiles from the healthy human body. J Breath Res 8: 014001. [Ref.]
  21. Hlastala MP, Anderson JC (1985) Alcohol breath test: gas exchange issues. J Appl Physiol 121: 367-375. [Ref.]
  22. Ruzsányi V, Péter Kalapos M (2017) Breath acetone as a potential marker in clinical practice. J Breath Res 11: 024002. [Ref.]
  23. Yamada YI, Yamada G, Otsuka M, Nishikiori H, Ikeda K, et al. (2017) Volatile Organic Compounds in Exhaled Breath of Idiopathic Pulmonary Fibrosis for Discrimination from Healthy Subjects. Lung 195: 247-254. [Ref.]
  24. Pinches SE, Apps P (2007) Production in food of 1,3-pentadiene and styrene by Trichoderma species. Int J Food Microbiol 116: 182-185.
  25. Grogan DW, Cronan JE (1997) Cyclopropane ring formation in membrane lipids of bacteria. Microbiol Mol Biol Rev 4: 429-441. [Ref.]
  26. Raninen KJ, Lappi JE, Mukkala ML, Tuomainen TP, Mykkänen HM, et al. (2016) Fiber content of diet affects exhaled breath volatiles in fasting and postprandial state in a pilot crossover study. Nutr Res 36: 612-619. [Ref.]
  27. Saalberg Y, Wolff M (2016) VOC breath biomarkers in lung cancer. Clin Chim Acta 459: 5-9. [Ref.]
  28. Staerz A, Weimar U, Barsan N (2016) Understanding the Potential of WO Based Sensors for Breath Analysis. Sensors (Basel) 16. [Ref.]
  29. Bone E, Tamm A, Hill M (1976) The production of urinary phenols by gut bacteria and their possible role in the causation of large bowel cancer. Am J Clin Nutr 29: 1448-1454. [Ref.]
  30. Meuric V, Le Gall-David S, Boyer E, Acuña-Amador L, Martin B, et al. (2017) Signature of Microbial Dysbiosis in Periodontitis. Appl Environ Microbiol 83. [Ref.]
  31. Suda R, Kurihara C, Kurihara M, Sato T, Lai CH, et al. (2003) Determination of eight selected periodontal pathogens in the subgingival plaque of maxillary first molars in Japanese school children aged 8-11 years. J Periodontal Res 38: 28-35. [Ref.]
  32. Ahmed WM, Lawal O, Nijsen TM, Goodacre R, Fowler SJ (2017) Exhaled Volatile Organic Compounds of Infection: A Systematic Review.ACS Infect Dis 3: 695-710. [Ref.]
  33. Bergmann A, Trefz P, Fischer S, Klepik K, Walter G, et al. (2015) In vivo Volatile Organic Compound Signatures of Mycobacterium avium subsp. paratuberculosis. PLoS One 10: e0123980. [Ref.]
  34. Suarez-Cuartin G, Giner J, Merino JL, Rodrigo-Troyano A, Feliu A, et al. (2018) Identification of Pseudomonas aeruginosa and airway bacterial colonization by an electronic nose in bronchiectasis. Respir Med 136: 111-117. [Ref.]
  35. Gao J, Zou Y, Wang Y, Wang F, Lang L, et al. (2016) Breath analysis for noninvasively differentiating Acinetobacter baumannii ventilatorassociated pneumonia from its respiratory tract colonization of ventilated patients. J Breath Res 10: 027102. [Ref.]
  36. Poger D, Mark AE (2015) A ring to rule them all: the effect of cyclopropane fatty acids on the fluidity of lipid bilayers. J Phys Chem B 17: 5487-5495. [Ref.]
  37. Krieg NR, Ludwig W, Whitman WB, Hedlund BP, Paster BJ, et al. (2011) Bergey’s Manual of Systematic Bacteriology: Volume 4: The Bacteroidetes, Spirochaetes, Tenericutes (Mollicutes), Acidobacteria, Fibrobacteres, Fusobacteria, Dictyoglomi, Gemmatimonadetes, Lentisphaerae, Verrucomicrobia, Chlamydiae, and Planctomycetes. New York: Springer. [Ref.]
  38. Boyanova L (2011) Helicobacter pylori. Haverhill (UK): Caister Academic Press. [Ref.]
  39. Sheppard SK (2014) Campylobacter. Campylobacter Ecology and Evolution. Haverhill (UK): Caister Academic Press. [Ref.]
  40. Haque M, Hirai Y, Yokota K, Mori N, Jahan I, et al (1996) Lipid profile of Helicobacter spp: presence of cholesteryl glucoside as a characteristic feature. J Bacteriol 178: 2065-2070. [Ref.]
  41. Coloe PJ, Slattery JF, Cavanaugh P, Vaughan J (1986) The cellular fatty acid composition of Campylobacter species isolated from cases of enteritis in man and animals. J Hyg (Lond) 2: 225-229. [Ref.]
  42. McNally DJ, Jarrell HC, Khieu NH, Li J, Vinogradov E, et al. (2006) The HS:19 serostrain of Campylobacter jejuni has a hyaluronic acid-type capsular polysaccharide with a nonstoichiometric sorbose branch and O-methyl phosphoramidate group. FEBS J 273: 3975-3989. [Ref.]
  43. Aspinall GO, Fujimoto S, McDonald AG, Pang H, Kurjanczyk LA, et al. (1994) Lipopolysaccharides from Campylobacter jejuni associated with Guillain-Barré syndrome patients mimic human gangliosides in structure. Infect Immun 62: 2122-2125. [Ref.]
  44. Jee SR, Morales W, Low K, Chang C, Zhu A, et al. (2010) ICC density predicts bacterial overgrowth in a rat model of post-infectious IBS. World J Gastroenterol 16: 3680-3686. [Ref.]
  45. Pimentel M, Morales W, Pokkunuri V, Brikos C, Kim SM, et al. (2015) Autoimmunity Links Vinculin to the Pathophysiology of Chronic Functional Bowel Changes Following Campylobacter jejuni Infection in a Rat Model. Dig Dis Sci 60: 1195-1205. [Ref.]
  46. Sung J, Morales W, Kim G, Pokkunuri V, Weitsman S, et al. (2013) Effect of repeated Campylobacter jejuni infection on gut flora and mucosal defense in a rat model of post infectious functional and microbial bowel changes. Neurogastroenterol Motil 25: 529-537. [Ref.]
  47. Brauner A, Brandt L, Frisan T, Thelestam M, Ekbom A (2010) Is there a risk of cancer development after Campylobacter infection? Scand J Gastroenterol 45: 893-897. [Ref.]
  48. Mai X, Genco RJ, LaMonte MJ, Hovey KM, Freudenheim JL, et al. (2016) Periodontal Pathogens and Risk of Incident Cancer in Postmenopausal Females: The Buffalo OsteoPerio Study. J Periodontol 87: 257-267. [Ref.]
  49. Dwivedi R, Nothaft H, Reiz B, Whittal RM, Szymanski CM (2013) Generation of free oligosaccharides from bacterial protein N-linked glycosylation systems.Biopolymers 99: 772-783. [Ref.]

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Article Information

Article Type: CASE REPORT

Citation: Bruno D, Fanny B, Jeremy P, Mathilde G, Amandine F, et al. (2018) Higher Levels of Exhaled Dimethylcyclopropane in Patients with Small Intestinal Bowel Overgrowth, Periodontitis when Associated with a Medical History of Cancer. J Clin Case Stu 3(4): 4925.175

Copyright: © 2018 Bruno D, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication history: 

  • Received date: 21 Sep, 2018

  • Accepted date: 01 Oct, 2018

  • Published date: 06 Oct, 2018