CSF levels of HoxB3 and YKL-40 may predict conversion from clinically isolated syndrome to relapsing remitting multiple sclerosis.

Yusuf Tamam, Betul Gunes, Ece Akbayir, Tugce Kizilay, Zerrin Karaaslan, Gizem Koral, Berna Duzel, Cem Ismail Kucukali, Tuncay Gunduz, Murat Kurtuncu, Vuslat Yilmaz, Erdem Tuzun, Recai Turkoglu

Multiple sclerosis and related disorders 2021 Feb

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Multiple sclerosis (MS) often initiates with an acute episode of neurological disturbance, known as clinically isolated syndrome (CIS). There is an unmet need for biomarkers that differentiate patients who will convert to MS and who will remain as CIS after the first attack. First attack serum and cerebrospinal fluid (CSF) samples of 33 CIS patients were collected and these patients were divided as those who converted to MS (CIS-MS, n=17) and those who continued as CIS (CIS-CIS, n=16) in a 3-year follow-up period. Levels of homeobox protein Hox-B3 (HoxB3) and YKL-40 were measured by ELISA in samples of CIS-CIS, CIS-MS, relapsing remitting MS (RRMS) patients (n=15) and healthy controls (n=20). CIS-CIS patients showed significantly reduced CSF levels of YKL-40 and increased serum/CSF levels of HoxB3 compared with CIS-MS and RRMS patients. CIS-MS and RRMS patients had comparable YKL-40 and HoxB3 level profiles. Receiver operating characteristic (ROC) curve analysis showed the highest sensitivity for CSF HoxB3 measurements in prediction of CIS-MS conversion. Kaplan-Meier analysis demonstrated that CIS patients with lower CSF HoxB3 (<3.678 ng/ml) and higher CSF YKL-40 (>654.9 ng/ml) displayed a significantly shorter time to clinically definite MS. CSF levels of HoxB3 and YKL-40 appear to predict CIS to MS conversion, especially when applied in combination. HoxB3, which is a transcription factor involved in immune cell activity, stands out as a potential candidate molecule with biomarker capacity for MS. Copyright © 2020. Published by Elsevier B.V.

Citation

Yusuf Tamam, Betul Gunes, Ece Akbayir, Tugce Kizilay, Zerrin Karaaslan, Gizem Koral, Berna Duzel, Cem Ismail Kucukali, Tuncay Gunduz, Murat Kurtuncu, Vuslat Yilmaz, Erdem Tuzun, Recai Turkoglu. CSF levels of HoxB3 and YKL-40 may predict conversion from clinically isolated syndrome to relapsing remitting multiple sclerosis. Multiple sclerosis and related disorders. 2021 Feb;48:102697