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All sTBI subjects (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a024) had mild injuries, whereas eight of the mtTBI subjects had moderate, and 17 had mild injuries. Plasma levels of ADEs were decreased after acute sTBI and returned to normal within months. Cprotein levels in ADEs were from 12\u2010 to 35\u2010fold higher than the corresponding levels in neuron\u2010derived exosomes. CD81 exosome marker\u2010normalized ADE levels of classical pathway C4b, alternative pathway factor D and Bb, lectin pathway mannose\u2010binding lectin (MBL), and shared neurotoxic effectors C3b and C5b\u20109 terminal C complex were significantly higher and those of C regulatory proteins CR1 and CD59 were lower in the first week of acute sTBI (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a012) than in controls (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a012). Most C abnormalities were no longer detected in chronic sTBI at 3\u201012 months after acute sTBI, except for elevated levels of factor D, Bb, and MBL. In contrast, significant elevations of ADE levels of C4b, factor D, Bb, MBL, C3b and C5b\u20109 terminal C complex, and depressions of CR1 and CD59 relative to those of controls were observed after 1\u20104 years in early chronic mtTBI (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a010) and persisted for decades except for normalization of Bb, MBL, and CD59 in late chronic mtTBI (\n                    <jats:italic>n<\/jats:italic>\n                    \u00a0=\u00a015). Complement inhibitors may be useful therapeutically in acute TBI and post\u2010concussion syndrome.\n                  <\/jats:p>","DOI":"10.1096\/fj.201902842r","type":"journal-article","created":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:48:21Z","timestamp":1578530901000},"page":"3359-3366","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":71,"title":["Traumatic brain injury increases plasma astrocyte\u2010derived exosome levels of neurotoxic complement proteins"],"prefix":"10.1096","volume":"34","author":[{"given":"Edward J.","family":"Goetzl","sequence":"first","affiliation":[{"name":"Department of Medicine University of California Medical Center San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Yaffe","sequence":"additional","affiliation":[{"name":"Neurology\u2010Psychiatry University of California Medical Center San Francisco CA USA"},{"name":"Department of Psychiatry San Francisco VA Medical Center San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie B.","family":"Peltz","sequence":"additional","affiliation":[{"name":"Department of Psychiatry San Francisco VA Medical Center San Francisco CA USA"},{"name":"Northern California Institute for Research and Education San Francisco CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aur\u00e9lie","family":"Ledreux","sequence":"additional","affiliation":[{"name":"Knoebel Institute for Healthy Aging University of Denver Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Gorgens","sequence":"additional","affiliation":[{"name":"Graduate School of Professional Psychology University of Denver Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Mechanical and Materials Engineering University of Denver Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann\u2010Charlotte","family":"Granholm","sequence":"additional","affiliation":[{"name":"Knoebel Institute for Healthy Aging University of Denver Denver CO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Mustapic","sequence":"additional","affiliation":[{"name":"Laboratory for Clinical Investigation National Institute on Aging Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Kapogiannis","sequence":"additional","affiliation":[{"name":"Laboratory for Clinical Investigation National Institute on Aging Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Tweedie","sequence":"additional","affiliation":[{"name":"Translational Gerontology Branch National Institute on Aging Baltimore MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel H.","family":"Greig","sequence":"additional","affiliation":[{"name":"Translational Gerontology Branch National Institute on Aging Baltimore MD 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