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Unfortunately, the collection of these samples involves relatively invasive procedures and is resource-demanding, limiting its regular use. Non-invasive samples from the upper airways could constitute an interesting alternative, but its relationship with COPD is still underexplored. We examined the merits of saliva to identify the typical profile of COPD oral bacteria and test its association with the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Outpatients with COPD and age-sex matched healthy controls were recruited and characterised based on clinical parameters and 16S rRNA profiling of oral bacteria. A clustering analysis based on patients\u2019 oral bacteria beta-diversity and logistic regressions were performed to evaluate the association between oral bacteria\u00a0composition and COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      128 individuals participated (70 patients and 58 controls). Differential abundance analyses showed differences in patients comparable to the ones previously observed in samples from the lower respiratory tract,\n                      <jats:italic>i.e<\/jats:italic>\n                      ., an increase in Proteobacteria (particularly\n                      <jats:italic>Haemophilus<\/jats:italic>\n                      ) and loss of microbiota diversity. An unsupervised clustering analysis separated patients in two groups based on microbiota composition differing significantly in the frequency of patients hospitalized due to severe acute exacerbation of COPD (AECOPD) and in the frequency of GOLD D patients. Furthermore, a low frequency of\n                      <jats:italic>Prevotella<\/jats:italic>\n                      was associated with a significantly higher risk of recent severe AECOPD and of being GOLD D.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Salivary bacteria showed an association with COPD, particularly with severe exacerbations, supporting the use of this non-invasive specimen for future studies of heterogeneous respiratory diseases like COPD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12931-022-01935-9","type":"journal-article","created":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T02:02:43Z","timestamp":1643421763000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Saliva as a non-invasive specimen for COPD assessment"],"prefix":"10.1186","volume":"23","author":[{"given":"Sara","family":"Melo-Dias","sequence":"first","affiliation":[]},{"given":"Carla","family":"Valente","sequence":"additional","affiliation":[]},{"given":"L\u00edlia","family":"Andrade","sequence":"additional","affiliation":[]},{"given":"Alda","family":"Marques","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8541-5720","authenticated-orcid":false,"given":"Ana","family":"Sousa","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2022,1,29]]},"reference":[{"key":"1935_CR1","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1042\/ETLS20170043","volume":"1","author":"GB Rogers","year":"2017","unstructured":"Rogers GB. 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Ethical approvals were obtained from Administra\u00e7\u00e3o Regional de Sa\u00fade Centro (64\/2016) and from Centro Hospitalar do Baixo Vouga (08-03-17). Written informed consent was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"S. Melo-Dias has nothing to disclose. C. Valente has nothing to disclose. L. Andrade has nothing to disclose. A. Marques has nothing to disclose. A. Sousa has nothing to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"16"}}