Multi-omics integration explores shared transcriptomic and immune signatures between pediatric Kawasaki disease and asthma

Kawasaki disease (KD), the most common acquired heart disease in children with rising global incidence, significantly increases risk for later allergic diseases. KD-asthma comorbidity escalates medical needs and treatment complexity, necessitating a deeper understanding of their relationship. Therefore, this study aimed to explore shared transcriptomic profiles, immune cell landscapes, and key susceptibility genes between pediatric KD and asthma through multi-omics integration.

This study retrospectively analyzed allergic disease incidence in KD patients at the Department of Cardiology, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, and recruited 13 KD-asthma children for single-cell RNA sequencing. Common susceptibility genes were identified through literature mining and differential analysis of public datasets. Bioinformatics methods explored immune cell landscapes, gene expression profiles, and functional characteristics.

Retrospective analysis of 222 pediatric KD patients revealed that 47.74% later developed allergic diseases. A systematic review of nearly 5,000 articles identified shared susceptibility genes significantly enriched in immune processes and signaling pathways. Single-cell RNA sequencing of 13 children showed distinct immune cell compositions and expression profiles versus controls. Both diseases exhibited enrichment of inflammatory and extracellular vesicle-related genes. Molecular function analysis showed that asthma differentially expressed genes primarily involved antigen binding and major histocompatibility complex (MHC) class II protein complex binding, while KD genes involved Toll-like receptor binding and calcium-dependent protein binding.

This study suggests a potential immunological link between KD and subsequent allergic conditions. Shared susceptibility genes and transcriptomic profiles are significantly enriched in inflammatory and vesicle-related pathways, providing insights into the biological overlap between these conditions.