The effectiveness of pulmonary rehabilitation in COPD is associated with specific shifts in oral microbiota

Abstract

Pulmonary Rehabilitation (PR) is the most cost-effective therapy for chronic obstructive pulmonary disease (COPD), but not all patients are responsive. The reasons behind this and the role of the airway microbiota in PR effectiveness are currently unknown. Here, we explored the effects of PR on oral microbiota and inflammatory markers and the associations of observed changes with responsiveness to PR. 456 saliva samples and data on exercise capacity, dyspnoea, and health-related quality of life were collected from 76 patients, of whom half participated in a 12-weeks PR programme. PR responsiveness was defined as overcoming the minimal clinically important difference of the measure assessed. PR modulated patientsʼ microbiota composition as well as the levels of IL-1β, TNF-α, and IL-10. Distinct patterns of longitudinal correlation between bacteria and inflammatory markers were also observed among responders (R) and non-responders (NR). Particularly, the longitudinal dynamic of Lautropia (Burkholderiaceae family) was significantly different between R and NR to exercise capacity, with NR having higher frequencies by the end of PR. Additionally, Lautropia was highly positively correlated with most of the inflammatory markers quantified (e.g., TNF- α, IL-6, IL-18) in NR to exercise capacity. Future studies should address the implications and stability of these microbiota modifications.