Related Experiment Video
Updated: Aug 5, 2026
12:36
Single-cell Analysis of Immunophenotype and Cytokine Production in Peripheral Whole Blood via Mass Cytometry
Published on: June 26, 2018
Monocyte Single-Cell-Type Gene Expression Analysis Differentiates Kawasaki Disease From Viral Infection With High
Nelson L S Tang1,2,3,4, Tsz-Ki Kwan2, Assunta C H Ho5
1Department of Chemical Pathology and Li Ka Shing Institute of Health Science, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Journal of Cellular and Molecular Medicine
|July 30, 2026
Summary
A new biomarker assay can help distinguish Kawasaki disease (KD) from viral infections (VD). The IFI27/PSAP ratio shows high diagnostic performance, potentially serving as a simple exclusion test for viral infections.
Area of Science:
- Immunology
- Molecular Diagnostics
- Pediatric Infectious Diseases
Background:
- Kawasaki disease (KD) and viral infections (VD) present similar symptoms, necessitating accurate differential diagnosis for appropriate treatment.
- Current diagnostic methods lack a simple biomarker to reliably distinguish between KD and VD.
- Large gene panels are impractical for routine clinical use.
Purpose of the Study:
- To evaluate novel ratio-based biomarkers for distinguishing KD from VD.
- To assess the diagnostic performance of Direct Leukocyte Single-cell-type Transcript Abundance (DIRECT LS-TA) assay using interferon-stimulated genes.
- To determine if a simple ratio assay can serve as a clinically useful exclusion test for viral infections.
Main Methods:
- Utilized public blood transcriptome datasets (GSE73461, GSE68004) from KD and VD patients.
- Calculated three ratio biomarkers (IFI27/PSAP, IFI44L/PSAP, SIGLEC1/PSAP) using the DIRECT LS-TA assay.
- Compared the diagnostic performance of these ratios against a conventional interferon (IFN) score derived from eight genes.
Main Results:
- Viral infection (VD) patients exhibited significantly elevated interferon (IFN)-related biomarkers compared to KD patients.
- The IFI27/PSAP ratio demonstrated the most substantial increase in VD patients.
- The IFI27/PSAP ratio achieved high diagnostic performance (AUC 0.90), slightly outperforming the conventional IFN score (AUC 0.89).
Conclusions:
- Low or absent interferon activation suggests against viral infection (VD) and supports a diagnosis of Kawasaki disease (KD).
- The simple IFI27/PSAP ratio assay shows promise as a clinically valuable tool for excluding viral infections.
- This assay offers a practical approach for differentiating KD from VD in clinical settings.