Objectives/Goals: This study aims to explore the relationship between plasma biomarkers (GFAP, NF-L, and IL-1β) and cognitive impairment in moderate to severe TBI patients. We will assess biomarker levels and their link to neurocognitive outcomes at acute and chronic stages of injury. Methods/Study Population: We will recruit 100 patients aged 21 years and older with moderate to severe TBI (Glasgow Coma Score 3–12) from a trauma hospital. Blood samples will be collected at 24–72 hours post-injury and again at 3 and 6 months. Plasma levels of GFAP, NF-L, and IL-1β will be measured using multiplex ELISA. Neurocognitive tests will be administered at 3 and 6 months to assess cognitive function. Correlations will be made between biomarker levels, neurocognitive performance, and disability scores (Disability Rating Scale and Glasgow Outcome Scale). Exosome isolation from plasma will allow for detailed analysis of astrocyte-derived biomarkers and their association with long-term cognitive impairment and recovery. Results/Anticipated Results: We anticipate that plasma levels of GFAP, NF-L, and IL-1β will be elevated in the acute phase of moderate to severe TBI and will correlate with injury severity. At 3 and 6 months, higher levels of IL-1β, in particular, are expected to be strongly associated with cognitive deficits. We also anticipate that biomarkers in astrocyte-derived exosomes will provide more specific insights into long-term neuroinflammation and its impact on cognitive function. These findings could pave the way for targeted, personalized interventions to improve recovery in TBI patients. Discussion/Significance of Impact: This research focuses on inflammation’s role in cognitive impairment and disability in TBI patients. We propose using multiple biomarkers – GFAP, IL-1β, NF-L – paired with advanced techniques like exosomes and multiplex analyses to identify novel therapeutic targets, aiming for personalized treatment strategies, as well as prognosis.