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There are, however, people who do not respond to PR and reasons for non-response are mostly unknown. PR is likely to change the airway microbiota and this could play a role in its responsiveness. In this study we have explored the association between PR effectiveness and specific alterations in oral microbiota and inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective longitudinal study was conducted. Data on exercise capacity, dyspnoea, impact of disease and 418 saliva samples were collected from 76 patients, half of whom participated in a 12-weeks PR programme. Responders and non-responders to PR (dyspnoea, exercise-capacity and impact of disease) were defined based on minimal clinically important differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Changes in microbiota, including\n                      <jats:italic>Prevotella melaninogenica<\/jats:italic>\n                      and\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      were observed upon PR.\n                      <jats:italic>Prevotella<\/jats:italic>\n                      , previously found to be depleted in severe COPD, increased during the first month of PR in responders. This increase was negatively correlated with\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      and\n                      <jats:italic>Lautropia<\/jats:italic>\n                      , known to be enriched in severe cases of COPD. Simultaneously, an anti-inflammatory commensal of the respiratory tract,\n                      <jats:italic>Rothia,<\/jats:italic>\n                      correlated strongly and negatively with several pro-inflammatory markers, whose levels were generally boosted by PR. Conversely, in non-responders, the observed decline in\n                      <jats:italic>Prevotella<\/jats:italic>\n                      correlated negatively with\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      and\n                      <jats:italic>Lautropia<\/jats:italic>\n                      whose fluctuations co-occurred with several pro-inflammatory markers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      PR is associated with changes in oral microbiota. Specifically, PR increases salivary\n                      <jats:italic>Prevotella melaninogenica<\/jats:italic>\n                      and avoids the decline in\n                      <jats:italic>Rothia<\/jats:italic>\n                      and the increase in\n                      <jats:italic>Streptococcus<\/jats:italic>\n                      and\n                      <jats:italic>Lautropia<\/jats:italic>\n                      in responders, which may contribute to the benefits of PR.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12931-023-02339-z","type":"journal-article","created":{"date-parts":[[2023,1,25]],"date-time":"2023-01-25T06:03:40Z","timestamp":1674626620000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Responsiveness to pulmonary rehabilitation in COPD is associated with changes in microbiota"],"prefix":"10.1186","volume":"24","author":[{"given":"Sara","family":"Melo-Dias","sequence":"first","affiliation":[]},{"given":"Miguel","family":"Cabral","sequence":"additional","affiliation":[]},{"given":"Andreia","family":"Furtado","sequence":"additional","affiliation":[]},{"given":"Sara","family":"Souto-Miranda","sequence":"additional","affiliation":[]},{"given":"Maria Aurora","family":"Mendes","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o","family":"Cravo","sequence":"additional","affiliation":[]},{"given":"Catarina Rodrigues","family":"Almeida","sequence":"additional","affiliation":[]},{"given":"Alda","family":"Marques","sequence":"additional","affiliation":[]},{"given":"Ana","family":"Sousa","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,1,25]]},"reference":[{"key":"2339_CR1","unstructured":"2022 GOLD Reports. 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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. M. Cabral has nothing to disclose. A. Furtado has nothing to disclose. S. Souto-Miranda has nothing to disclose. M. A. Mendes has nothing to disclose. J. Cravo has nothing to disclose. C. R. Almeida 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":"29"}}