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Human umbilical cord mesenchymal stem cells (hUC\u2010MSCs) hold promise due to their neuroprotective and immunomodulatory effects, but their underlying mechanisms remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study established a PND model in aged mice using tibial fracture intramedullary fixation surgery, followed by intravenous hUC\u2010MSCs administration. Subsequently, behavioral tests, pathological examination, proteomic analysis, and other experiments were performed to verify the therapeutic effect and underlying mechanism of hUC\u2010MSCs on PND in mice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>hUC\u2010MSCs significantly improved cognitive function in PND mice, reduced hippocampal neuronal apoptosis and neuroinflammation, and restored dendritic spine density. Mechanistically, hUC\u2010MSCs secreted \u03b2\u2010NGF to activate the TrkA signaling pathway, upregulate STMN2 and NMNAT2 expression, and inhibit the SARM1\/NF\u2010\u03baB pathway, thereby alleviating neuroinflammation and dendritic degeneration. Overexpression of SARM1 in the hippocampal CA1 region and \u03b2\u2010NGF knockdown in hUC\u2010MSCs both reversed the therapeutic effects of hUC\u2010MSCs, confirming their critical roles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>hUC\u2010MSCs ameliorate PND pathology through the \u03b2\u2010NGF\u2010mediated STMN2\/NMNAT2\u2010SARM1\u2010NF\u2010\u03baB pathway, offering a novel cell\u2010based therapeutic strategy for PND. Future research may focus on optimizing the secretory function of hUC\u2010MSCs or developing small\u2010molecule drugs targeting \u03b2\u2010NGF to enhance therapeutic efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.71062","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T14:38:37Z","timestamp":1785335917000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>hUC<\/scp>\n                    \u2010\n                    <scp>MSCs<\/scp>\n                    via \u03b2\u2010\n                    <scp>NGF<\/scp>\n                    Alleviate Cognitive Impairment After Tibial Fracture Surgery by Regulating the\n                    <scp>STMN2<\/scp>\n                    \/\n                    <scp>NMNAT2<\/scp>\n                    \u2010\n                    <scp>SARM1<\/scp>\n                    \u2010\n                    <scp>NF<\/scp>\n                    \u2010\n                    <scp>\u03baB<\/scp>\n                    Signaling Pathway"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8761-6187","authenticated-orcid":false,"given":"Kai","family":"Wang","sequence":"first","affiliation":[{"name":"The Affiliated Xuzhou Clinical College of Xuzhou Medical University  Xuzhou Jiangsu Province China"},{"name":"Department of Anesthesiology Xuzhou Central Hospital  Xuzhou Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangjun","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Xuzhou Clinical College of Xuzhou Medical University  Xuzhou Jiangsu Province China"},{"name":"Department of Anesthesiology Xuzhou Central Hospital  Xuzhou Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Xuzhou Central 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