Firdevs ULUC, Fatma BILGILI, Nevin HORASAN, Sule AYDIN TURKOGLU
Northwestern Medical Journal - 2026;6(2):167-173
Aim: Multiple sclerosis (MS) is a complex disease in terms of diagnosis and differential diagnosis due to the variety of clinical and radiological findings. Many diseases have similar characteristics and mimic MS. Thus, potential differential biomarkers have an importance for diagnosis of MS. Homeobox protein-3 (HOXB3) is a homeobox transcription factor implicated in immune cell regulation and neurodevelopment, and recent cerebrospinal fluid proteomic studies have suggested its potential role in neuroinflammatory processes, making it a plausible candidate biomarker for differential diagnosis in MS. The aim of this study was to investigate whether cerebrospinal fluid levels of HOXB3 differ between treatment-naïve patients with relapsing-remitting multiple sclerosis (RRMS) during relapse and patients with idiopathic intracranial hypertension (IIH). Methods: Forty-one pwMS diagnosed with McDonald criteria were enrolled for the case groups. Thirty-four patients with IIH diagnosed with Dandy criteria were enrolled for control group. We measured cerebrospinal fluid level of HOXB3 (CSF HOXB3) by Enzyme-Linked Immunosorbent Assay (ELISA) method. Results: No significant difference was observed in CSF HOXB3 levels between pwMS and control group. The ROC curve for HOXB3 was not statistically significant with the AUC at 0.573. Conclusion: HOXB3 does not differentiate RRMS from IIH under the studied conditions.
