Fig 1: Dysregulation of neuroserpin and tissue plasminogen activator (tPA) in plasma and cerebrospinal fluid (CSF) from people with Down syndrome (DS). A, Neuroserpin levels were assessed by Western blotting. No significant change in plasma neuroserpin levels were observed between clinical groups, one-way analysis of variance (ANOVA), P > .05. B, Neuroserpin levels were found upregulated in CSF from AD-asymptomatic people with Down syndrome (aDS) and from people with Down syndrome and symptomatic Alzheimer's disease (DSAD) compared to non-trisomic controls, Kruskal Wallis test P = .001 H = 13.63 and Dunn's post hoc correction; *P < .05; **P < .01. C, tPA levels were reduced in plasma from people with aDS and DSAD, compared to non-trisomic controls, one-way ANOVA, F = 12.07, P < .0001 and Bonferroni post hoc correction; *P < .05. D, No change between clinical classifications in CSF levels of tPA, one-way ANOVA, P > .05. tPA levels were determined by enzyme-linked immunosorbent assay. Data are displayed in box and whisker plots, in which the median is represented by the horizontal line and the whiskers go from each quartile to the minimum or maximum value. HC, Healthy controls: n = 16, aDS: n = 14, DSAD: n = 22; IOD, integrated optical density