Exploring Patients' Experiences and Perceptions of Stem Cell Therapy for Tissue Healing: An Interpretative Phenomenological Analysis (IPA)

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Johannes H.S
Handri Maika Saputra

Abstract

Stem cell therapy is an emerging field within regenerative medicine, offering potential solutions for tissue healing and regeneration. However, while clinical outcomes have been widely studied, less is known about the subjective experiences of patients undergoing such treatments. This study aims to address this gap by exploring the emotional and psychological aspects of patients' experiences with stem cell therapy. Using an Interpretative Phenomenological Analysis (IPA) approach, we examined the lived experiences of 12 patients (7 males and 5 females, aged between 35 and 65 years, diagnosed with musculoskeletal injuries) who underwent stem cell therapy at a specialized regenerative medicine clinic in Jakarta, Indonesiafor tissue healing. The analysis revealed that patients experienced a complex range of emotions, including hope, anxiety, and gradual acceptance, as they navigated the healing process. These findings highlight the significant psychological and emotional dimensions of stem cell therapy, which are often overlooked in clinical research. The results emphasize the importance of considering these factors in patient care and suggest the need for further exploration of the long-term impacts of regenerative therapies on emotional well-being. 

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Ahn, Y. J., Yun, W. S., Choi, J. S., Kim, W. C., Lee, S. H., Park, D. J., Park, J. E., Key, J., & Seo, Y. J. (2021). Biodistribution of poly clustered superparamagnetic iron oxide nanoparticle labeled mesenchymal stem cells in aminoglycoside induced ototoxic mouse model. Biomedical Engineering Letters, 11(1), 39–53. Scopus. https://doi.org/10.1007/s13534-020-00181-6

Attia, S. S., Rafla, M., El-Nefiawy, N. E., Abdel Hamid, H. F., Amin, M. A., & Fetouh, M. A. (2022). A potential role of mesenchymal stem cells derived from human umbilical cord blood in ameliorating psoriasis-like skin lesion in the rats. Folia Morphologica (Poland), 81(3), 614–631. Scopus. https://doi.org/10.5603/FM.a2021.0076

Barrera, J. A., Trotsyuk, A. A., Maan, Z. N., Bonham, C. A., Larson, M. R., Mittermiller, P. A., Henn, D., Chen, K., Mays, C. J., Mittal, S., Mermin-Bunnell, A. M., Sivaraj, D., Jing, S., Rodrigues, M., Kwon, S. H., Noishiki, C., Padmanabhan, J., Jiang, Y., Niu, S., … Gurtner, G. C. (2021). Adipose-Derived Stromal Cells Seeded in Pullulan-Collagen Hydrogels Improve Healing in Murine Burns. Tissue Engineering - Part A, 27(11–12), 844–856. Scopus. https://doi.org/10.1089/ten.tea.2020.0320

Bartunek, J., Terzic, A., Davison, B. A., Behfar, A., Sanz-Ruiz, R., Wojakowski, W., Sherman, W., Heyndrickx, G. R., Metra, M., Filippatos, G. S., Waldman, S. A., Teerlink, J. R., Henry, T. D., Gersh, B. J., Hajjar, R., Tendera, M., Senger, S., Cotter, G., Povsic, T. J., & Wijns, W. (2020). Cardiopoietic stem cell therapy in ischaemic heart failure: Long-term clinical outcomes. ESC Heart Failure, 7(6), 3345–3354. Scopus. https://doi.org/10.1002/ehf2.13031

Chen, K., Wang, H., Zhao, X., Wang, J., Jin, Q., Tong, X., & Zheng, S. (2024). A Novel Method to Repair Thin Endometrium and Restore Fertility Based on Menstruation-Derived Stem Cell. Reproductive Sciences, 31(6), 1662–1673. Scopus. https://doi.org/10.1007/s43032-024-01458-2

Choi, D. H., Oh, S.-Y., Choi, J. K., Lee, K. E., Lee, J. Y., Park, Y. J., Jo, I., & Park, Y. S. (2020). A transcriptomic analysis of serial-cultured, tonsil-derived mesenchymal stem cells reveals decreased integrin α3 protein as a potential biomarker of senescent cells. Stem Cell Research and Therapy, 11(1). Scopus. https://doi.org/10.1186/s13287-020-01860-y

Chung, H., Choi, J.-K., Hong, C., Lee, Y., Hong, K. H., Oh, S. J., Kim, J., Song, S.-C., Kim, J.-W., & Kim, S.-H. (2024). A micro-fragmented collagen gel as a cell-assembling platform for critical limb ischemia repair. Bioactive Materials, 34, 80–97. Scopus. https://doi.org/10.1016/j.bioactmat.2023.12.008

de Kanter, J. K., Peci, F., Bertrums, E., Rosendahl Huber, A., van Leeuwen, A., van Roosmalen, M. J., Manders, F., Verheul, M., Oka, R., Brandsma, A. M., Bierings, M., Belderbos, M., & van Boxtel, R. (2021). Antiviral treatment causes a unique mutational signature in cancers of transplantation recipients. Cell Stem Cell, 28(10), 1726-1739.e6. Scopus. https://doi.org/10.1016/j.stem.2021.07.012

Di Stefano, A. B., Grisafi, F., Perez-Alea, M., Castiglia, M., Di Simone, M., Meraviglia, S., Cordova, A., Moschella, F., & Toia, F. (2021). Cell quality evaluation with gene expression analysis of spheroids (3D) and adherent (2D) adipose stem cells. Gene, 768. Scopus. https://doi.org/10.1016/j.gene.2020.145269

Esmaeilzadeh, A., Ommati, H., Kooshyar, M. M., Jarahi, L., Rezayat, K. A., Saberi, S., Vosough, M., & Ghassemi, A. (2019). Autologous bone marrow stem cell transplantation in liver cirrhosis after correcting nutritional anomalies, a controlled clinical study. Cell Journal, 21(3), 268–273. Scopus. https://doi.org/10.22074/cellj.2019.6108

Fife, W. (2020). Counting as a Qualitative Method: Grappling with the Reliability Issue in Ethnographic Research (p. 140). Springer International Publishing; Scopus. https://doi.org/10.1007/978-3-030-34803-8

Hartman, R. E., Nathan, N. H., Ghosh, N., Pernia, C. D., Law, J., Nuryyev, R., Plaia, A., Yusof, A., Tone, B., Dulcich, M., Wakeman, D. R., Dilmac, N., Niles, W. D., Sidman, R. L., Obenaus, A., Snyder, E. Y., & Ashwal, S. (2020). A Biomarker for Predicting Responsiveness to Stem Cell Therapy Based on Mechanism-of-Action: Evidence from Cerebral Injury. Cell Reports, 31(6). Scopus. https://doi.org/10.1016/j.celrep.2020.107622

Huang, C.-C., Kang, M., Shirazi, S., Lu, Y., Cooper, L. F., Gajendrareddy, P., & Ravindran, S. (2021). 3D Encapsulation and tethering of functionally engineered extracellular vesicles to hydrogels. Acta Biomaterialia, 126, 199–210. Scopus. https://doi.org/10.1016/j.actbio.2021.03.030

Kawamura, Y. (2020). DOING RESEARCH IN FASHION AND DRESS: An Introduction to Qualitative Methods, 2nd edition (p. 166). Bloomsbury Publishing Plc.; Scopus. https://www.scopus.com/inward/record.uri?eid=2-s2.0-85188589040&partnerID=40&md5=b3db406659cd1ea5b20e05664bec39a3

Khajeh, S., Bozorg-Ghalati, F., Zare, M., Panahi, G., & Razban, V. (2021). Cartilage tissue and therapeutic strategies for cartilage repair. Current Molecular Medicine, 21(1), 56–72. Scopus. https://doi.org/10.2174/1566524020666200610170646

Kim, M., Bae, Y. K., Um, S., Kwon, J. H., Kim, G.-H., Choi, S. J., Oh, W., & Jin, H. J. (2020). A Small-Sized Population of Human Umbilical Cord Blood-Derived Mesenchymal Stem Cells Shows High Stemness Properties and Therapeutic Benefit. Stem Cells International, 2020. Scopus. https://doi.org/10.1155/2020/5924983

Kim, S. H., Kim, J. Y., Park, S. Y., Jeong, W. T., Kim, J. M., Bae, S. H., & Kim, G. J. (2021). Activation of the EGFR-PI3K-CaM pathway by PRL-1-overexpressing placenta-derived mesenchymal stem cells ameliorates liver cirrhosis via ER stress-dependent calcium. Stem Cell Research and Therapy, 12(1). Scopus. https://doi.org/10.1186/s13287-021-02616-y

Li, Q., Zhao, F., Li, Z., Duan, X., Cheng, J., Zhang, J., Fu, X., Zhang, J., Shao, Z., Guo, Q., Hu, X., & Ao, Y. (2020). Autologous Fractionated Adipose Tissue as a Natural Biomaterial and Novel One-Step Stem Cell Therapy for Repairing Articular Cartilage Defects. Frontiers in Cell and Developmental Biology, 8. Scopus. https://doi.org/10.3389/fcell.2020.00694

Malina, T., Poláková, K., Skopalík, J., Milotová, V., Holá, K., Havrdová, M., Tománková, K. B., Čmiel, V., Šefc, L., & Zbořil, R. (2019). Carbon dots for in vivo fluorescence imaging of adipose tissue-derived mesenchymal stromal cells. Carbon, 152, 434–443. Scopus. https://doi.org/10.1016/j.carbon.2019.05.061

Miao, S., Cui, H., Esworthy, T., Mahadik, B., Lee, S.-J., Zhou, X., Hann, S. Y., Fisher, J. P., & Zhang, L. G. (2020). 4D Self-Morphing Culture Substrate for Modulating Cell Differentiation. Advanced Science, 7(6). Scopus. https://doi.org/10.1002/advs.201902403

Mitra, A., Yan, J., Zhang, L., & Li, S. (2019). A small molecule Hedgehog agonist HhAg1.5 mediated reprogramming breaks the quiescence of noninjured liver stem cells for rescuing liver failure. Translational Research, 205, 44–50. Scopus. https://doi.org/10.1016/j.trsl.2018.10.004

Møller-Hansen, M., Larsen, A.-C., Wiencke, A. K., Terslev, L., Siersma, V., Andersen, T. T., Hansen, A. E., Bruunsgaard, H., Haack-Sørensen, M., Ekblond, A., Kastrup, J., Utheim, T. P., & Heegaard, S. (2024). Allogeneic mesenchymal stem cell therapy for dry eye disease in patients with Sjögren’s syndrome: A randomized clinical trial. Ocular Surface, 31, 1–8. Scopus. https://doi.org/10.1016/j.jtos.2023.11.007

Nazari, H., Naei, V. Y., Tabasi, A. H., Badripour, A., Asbagh, R. A., Keramati, M. R., Sharifi, A., Behboudi, B., Kazemeini, A., Abbasi, M., Keshvari, A., & Tafti, S. M. A. (2022). Advanced Regenerative Medicine Strategies for Treatment of Perianal Fistula in Crohn’s Disease. Inflammatory Bowel Diseases, 28(1), 133–142. Scopus. https://doi.org/10.1093/ibd/izab151

Nguyen Thanh, L., Dam, P. T. M., Nguyen, H.-P., Nguyen, T.-S. T., To, H. M., Nguyen, H. B., Luu, N.-A., & Hoang, D. M. (2021). Can Autologous Adipose-Derived Mesenchymal Stem Cell Transplantation Improve Sexual Function in People with Sexual Functional Deficiency? Stem Cell Reviews and Reports, 17(6), 2153–2163. Scopus. https://doi.org/10.1007/s12015-021-10196-w

Odeleye, A. O. O., Baudequin, T., Chui, C.-Y., Cui, Z., & Ye, H. (2020). An additive manufacturing approach to bioreactor design for mesenchymal stem cell culture. Biochemical Engineering Journal, 156. Scopus. https://doi.org/10.1016/j.bej.2020.107515

O’neill, H. C., Limnios, I. J., & Barnett, N. L. (2019). Advancing a stem cell therapy for age-related macular degeneration. Current Stem Cell Research and Therapy, 15(2), 89–97. Scopus. https://doi.org/10.2174/1574888X15666191218094020

Rafieerad, A., Yan, W., Sequiera, G. L., Sareen, N., Abu-El-Rub, E., Moudgil, M., & Dhingra, S. (2019). Application of Ti3C2 MXene Quantum Dots for Immunomodulation and Regenerative Medicine. Advanced Healthcare Materials, 8(16). Scopus. https://doi.org/10.1002/adhm.201900569

Ruane, J. J., Ross, A., Zigmont, V., McClure, D., & Gascon, G. (2021). A single-blinded randomized controlled trial of mesenchymal stem cell therapy for the treatment of osteoarthritis of the knee with active control. Journal of Stem Cells and Regenerative Medicine, 17(1). Scopus. https://doi.org/10.46582/JSRM.1701002

shojaei, E., Zare, S., Shirkavand, A., Eslami, E., Fathollah, S., & Mansouri, P. (2022). Biophysical evaluation of treating adipose tissue-derived stem cells using non-thermal atmospheric pressure plasma. Scientific Reports, 12(1). Scopus. https://doi.org/10.1038/s41598-022-14763-0

Wang, Q., Ma, X., Liao, H., Liang, Z., Li, F., Tian, J., & Ling, D. (2020). Artificially Engineered Cubic Iron Oxide Nanoparticle as a High-Performance Magnetic Particle Imaging Tracer for Stem Cell Tracking. ACS Nano, 14(2), 2053–2062. Scopus. https://doi.org/10.1021/acsnano.9b08660

Wgealla, M. M. A. M. A., Liang, H., Chen, R., Xie, Y., Li, F., Qin, M., & Zhang, X. (2022). Amniotic fluid derived stem cells promote skin regeneration and alleviate scar formation through exosomal miRNA-146a-5p via targeting CXCR4. Journal of Cosmetic Dermatology, 21(10), 5026–5036. Scopus. https://doi.org/10.1111/jocd.14956

Winter, R. L., Tian, Y., Caldwell, F. J., Seeto, W. J., Koehler, J. W., Pascoe, D. A., Fan, S., Gaillard, P., Lipke, E. A., & Wooldridge, A. A. (2020). Cell engraftment, vascularization, and inflammation after treatment of equine distal limb wounds with endothelial colony forming cells encapsulated within hydrogel microspheres. BMC Veterinary Research, 16(1). Scopus. https://doi.org/10.1186/s12917-020-2269-y

Yang, L., Liu, Y., Sun, L., Zhao, C., Chen, G., & Zhao, Y. (2022). Biomass Microcapsules with Stem Cell Encapsulation for Bone Repair. Nano-Micro Letters, 14(1). Scopus. https://doi.org/10.1007/s40820-021-00747-8

Yang, Z., Fan, Z., Wang, D., Li, H., He, Z., Xing, D., & Lin, J. (2023). Bibliometric and visualization analysis of stem cell therapy for meniscal regeneration from 2012 to 2022. Frontiers in Bioengineering and Biotechnology, 11. Scopus. https://doi.org/10.3389/fbioe.2023.1107209

Yu, X., He, Y., Chen, Z., Qian, Y., Wang, J., Ji, Z., Tan, X., Li, L., & Lin, M. (2019). Autologous decellularized extracellular matrix protects against H2O2-induced senescence and aging in adipose-derived stem cells and stimulates proliferation in vitro. Bioscience Reports, 39(5). Scopus. https://doi.org/10.1042/BSR20182137

Yun, B. G., Lee, S.-H., Jeon, J. H., Kim, S.-W., Jung, C. K., Park, G., Kim, S. Y., Jeon, S., Lee, M. S., Park, S. H., Jang, J., Yang, H. S., Cho, D.-W., Lim, J. Y., & Kim, S. W. (2019). Accelerated Bone Regeneration via Three-Dimensional Cell-Printed Constructs Containing Human Nasal Turbinate-Derived Stem Cells as a Clinically Applicable Therapy. ACS Biomaterials Science and Engineering, 5(11), 6171–6185. Scopus. https://doi.org/10.1021/acsbiomaterials.9b01356

Zhai, Y., Wang, Q., Zhu, Z., Zheng, W., Ma, S., Hao, Y., Yang, L., & Cheng, G. (2022). Cell-derived extracellular matrix enhanced by collagen-binding domain-decorated exosomes to promote neural stem cells neurogenesis. Biomedical Materials (Bristol), 17(1). Scopus. https://doi.org/10.1088/1748-605X/ac4089

Zhang, S., Zhu, D., Li, Z., Huang, K., Hu, S., Lutz, H., Xie, M., Mei, X., Li, J., Neal-Perry, G., Wang, S., & Cheng, K. (2021). A stem cell-derived ovarian regenerative patch restores ovarian function and rescues fertility in rats with primary ovarian insufficiency. Theranostics, 11(18), 8894–8908. Scopus. https://doi.org/10.7150/thno.61690

Zhong, Z., Balayan, A., Tian, J., Xiang, Y., Hwang, H. H., Wu, X., Deng, X., Schimelman, J., Sun, Y., Ma, C., Santos, A. D., You, S., Tang, M., Yao, E., Shi, X., Steinmetz, N. F., Deng, S. X., & Chen, S. (2021). Bioprinting of dual ECM scaffolds encapsulating limbal stem/progenitor cells in active and quiescent statuses. Biofabrication, 13(4). Scopus. https://doi.org/10.1088/1758-5090/ac1992

Zhu, W., Chen, L., Wu, Z., Li, W., Liu, X., Wang, Y., Guo, M., Ito, Y., Wang, L., Zhang, P., & Wang, H. (2022). Bioorthogonal DOPA-NGF activated tissue engineering microunits for recovery from traumatic brain injury by microenvironment regulation. Acta Biomaterialia, 150, 67–82. Scopus. https://doi.org/10.1016/j.actbio.2022.07.018