Table 3_Combination of CRP and miRNA signature as a potential diagnostic strategy for Kawasaki disease.xlsx

BackgroundKawasaki disease is the leading cause of acquired heart disease in children, yet timely diagnosis remains difficult due to overlapping symptoms with other febrile illnesses.
MethodsIn a retrospective case–control study of 38 children with Kawasaki disease and 44 febrile controls, we measured hematological parameters and C-reactive protein (CRP) using standardized analyzers and profiled seven serum microRNAs by qRT-PCR. Biomarkers showing significant differences were used to build logistic regression models with a 70/30 train–test split, and diagnostic accuracy was assessed by receiver operating characteristic analysis. Functional enrichment of miRNA targets was explored using network analysis.
ResultsCRP and three microRNAs (miR-223-3p, miR-19a-3p, miR-18a-5p) were significantly elevated in Kawasaki disease. Individually, these markers achieved strong discrimination (AUC: 0.846–0.986), while their combination yielded an AUC of 0.990, sensitivity 1.000, and specificity 0.923. The three microRNAs were positively correlated and enriched for pathways including p53 signaling and cell cycle regulation, with KCNQ1OT1 identified as a shared lncRNA interactor.
ConclusionIntegrating CRP with a concise serum miRNA panel demonstrates promising discriminatory potential for Kawasaki disease vs. other febrile illnesses and suggests mechanistic involvement of p53-associated pathways, supporting future validation in larger, independent cohorts.

背景：川崎病（Kawasaki disease）是儿童获得性心脏病的首要致病原因，但由于其症状与其他发热性疾病存在重叠，及时诊断仍颇具挑战。
方法：本研究纳入38例川崎病患儿与44例发热对照患儿，开展回顾性病例对照研究。采用标准化分析仪检测血液学参数与C反应蛋白（CRP），并通过实时定量逆转录聚合酶链反应（qRT-PCR）分析7种血清微小RNA（microRNA）的表达谱。筛选差异显著的生物标志物构建训练集与测试集按7:3比例划分的逻辑回归模型，通过受试者工作特征（ROC）分析评估诊断效能；同时利用网络分析探究miRNA靶基因的功能富集情况。
结果：川崎病患儿的CRP与3种miRNA（miR-223-3p、miR-19a-3p、miR-18a-5p）表达水平显著升高。单一标志物即具备优异的判别能力，曲线下面积（AUC）介于0.846至0.986之间；联合检测的AUC可达0.990，灵敏度为1.000，特异度为0.923。上述3种miRNA呈正相关，其靶基因显著富集于p53信号通路、细胞周期调控等通路，同时鉴定出KCNQ1OT1为共享的长链非编码RNA（lncRNA）互作分子。
结论：将CRP与精简的血清miRNA检测组合相结合，在区分川崎病与其他发热性疾病方面展现出极具前景的判别效能，同时提示p53相关通路参与疾病发生的分子机制，为后续在更大规模独立队列中开展验证研究提供了支撑。