Uncovering the role of microbiota and fecal microbiota transplantation in Crohn’s disease: Current advances and future hurdles

Table 4 Role of fecal microbiota transplantation in Crohn’s disease

Ref.	Type of study	Participants	Findings	Conclusion
Sokol et al[29]	RCT	8 received FMT. 9 received sham transplantation	Flare-up in 3/8 in FMT group. Flare-up in 6/9 in sham group. Higher decrease in CDEIS in FMT group	Difference in flare-up was not statistically significant. Limitations: Small sample size; low baseline CDEIS sham group
He et al[30]	Prospective cohort study	25 CD patients received multiple FMTs at 3-month interval. No control group	Remission induced in 52%. Sustained remission decreased overtime: 48% at 6 months. 32% at 12 months. 22.7% at 18 months	Some efficacy in inducing clinical remission. Effect diminished despite repeated administrations. Limitations: Lack of control group, small sample size, absence of endoscopic evaluation
Suskind et al[31]	Open label study	9 CD patients. No control group	7/9 achieved remission at 2 weeks. 5/9 showed persistent remission after 6 and 12 weeks	Potential benefits of FMT. Limitations: No control group, small sample size. Inclusion of antibiotics. Continuation of immunomodulators after FMT
Wang et al[32]	Prospective cohort study	139 CD patients. No control group	Remission in 56%. Adverse effects (AE) in 13.6% (25/139). AE in 84% resolved without treatment. AE in 16% needed medications. AE rate 217% in manual FMT preparation group vs 8.7% in automated machine-operated group	FMT generally safe. Automated purification method safer than manual method. Reasonable remission rate
Xiang et al[33]	Prospective cohort study	174 CD patients. No control group	43% achieved clinical remission. Sustained remission in 20.1% at 43 months. Frozen FMT showed 11.3% lower response compared to fresh FMT	Potential benefits of FMT in CD patients. Limitations: No control group. Lack of biomarkers. Lack of endoscopic findings
Yang et al[34]	Prospective cohort study	27 CD patients 14 received FMT via colonoscopy and 13 via gastroscopy. No control group. Follow-up period – 8 weeks	Clinical remission in 66.7%. No difference between colonoscopy (64.3) vs gastroscopy (69.2%) group. Clinical response in 77.8%. No difference between colonoscopy (78.6) vs gastroscopy (76.9%) group	Potential benefits of FMT. Limitations: No control group. Short follow-up period

RCT: Randomized controlled trial; FMT: Fecal microbiota transplantation; CDEIS: Crohn’s disease endoscopic index of severity; CD: Crohn’s disease; AE: Adverse effect.