{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:35:58Z","timestamp":1791336958450,"version":"4.3.1"},"reference-count":50,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000320","name":"Alzheimer's Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000320","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Down syndrome (DS) is associated with immune dysregulation and a high risk of early onset Alzheimer's disease (AD). Complement is a key part of innate immunity and driver of pathological inflammation, including neuroinflammation in AD. Complement dysregulation has been reported in DS; however, the pattern of dysregulation and its relationship to AD risk is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Plasma levels of 14 complement biomarkers were measured in 71 adults with DS and 46 controls to identify DS\u2010associated dysregulation; impact of apolipoprotein E (<jats:italic>APOE<\/jats:italic>) \u03b54 genotype, single nucleotide polymorphisms (SNPs) in <jats:italic>CLU<\/jats:italic> and <jats:italic>CR1<\/jats:italic>, and dementia on complement biomarkers was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Plasma levels of complement activation products (TCC, iC3b), proteins (C1q, C3, C9), and regulators (C1 inhibitor, factor H, FHR4, clusterin) were significantly elevated in DS versus controls while FI and sCR1 were significantly lower. In DS with AD (<jats:italic>n<\/jats:italic> = 13), C3 and FI were significantly decreased compared to non\u2010AD DS (<jats:italic>n<\/jats:italic> = 58). Neither <jats:italic>APOE<\/jats:italic> genotype nor <jats:italic>CLU<\/jats:italic> SNPs impacted complement levels, while rs6656401 in <jats:italic>CR1<\/jats:italic> significantly impacted plasma sCR1 levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Complement is dysregulated in DS, likely reflecting the generalized immune dysregulation state; measurement may help identify inflammatory events in individuals with DS. Complement biomarkers differed in DS with and without AD and may aid diagnosis and\/or prediction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Complement is significantly dysregulated in plasma of people with DS who show changes in levels of multiple complement proteins compared to controls.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>People with DS and dementia show evidence of additional complement dysregulation with significantly lower levels of C3 and factor I compared to those without dementia.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>rs6656401 in CR1 was associated with significantly elevated sCR1 plasma levels in DS.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.12799","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T08:59:02Z","timestamp":1663923542000},"page":"1383-1392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Complement dysregulation and Alzheimer's disease in Down syndrome"],"prefix":"10.1002","volume":"19","author":[{"given":"Aurora","family":"Veteleanu","sequence":"first","affiliation":[{"name":"School of Medicine UK Dementia Research Institute Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Pape","sequence":"additional","affiliation":[{"name":"Department of Forensic and Neurodevelopmental Science Institute of Psychiatry Psychology and Neuroscience King's College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Davies","sequence":"additional","affiliation":[{"name":"School of Medicine, Division of Infection and Immunity Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleftheria","family":"Kodosaki","sequence":"additional","affiliation":[{"name":"School of Medicine, Division of Infection and Immunity Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Hye","sequence":"additional","affiliation":[{"name":"Department of Forensic and Neurodevelopmental Science Institute of Psychiatry Psychology and Neuroscience King's College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wioleta M.","family":"Zelek","sequence":"additional","affiliation":[{"name":"School of Medicine UK Dementia Research Institute Cardiff University  Cardiff UK"},{"name":"School of Medicine, Division of Infection and Immunity Cardiff University  Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Strydom","sequence":"additional","affiliation":[{"name":"Department of Forensic and Neurodevelopmental Science Institute of Psychiatry Psychology and Neuroscience King's College  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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