Abstract

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.

Keywords: multiple sclerosis, human homeobox protein-3, cerebrospinal fluid, biomarker

Copyright and license

Copyright © 2026 The Author(s). This is an open-access article published by Bolu İzzet Baysal Training and Research Hospital under the terms of the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Uluc F, Bilgili F, Horasan N, Aydin Turkoglu S. Cerebrospinal fluid HOXB3 does not differentiate relapsing–remitting multiple sclerosis from idiopathic intracranial hypertension: a pilot study. Northwestern Med J. 2026;6(2):167-73. https://doi.org/10.54307/2026.NWMJ.211

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