Whole Transcriptome Insight into Kawasaki Disease

Kawasaki disease (KD) is an acute pediatric vasculitis and the leading cause of acquired heart disease in children, with coronary artery aneurysm representing its most serious complication. Despite decades of investigation, the molecular mechanisms underlying the disease onset remain incompletely defined, and clinically reliable biomarkers for accurate diagnosis and prognostic stratification have yet to be established. In recent years, transcriptomic analysis has emerged as systems-level strategy for elucidating disease pathobiology and advancing biomarker and therapeutic target discovery, and has been increasingly applied to complex immune-mediated disorders such as KD. Whole-blood gene expression studies in KD have demonstrated reproducible perturbations in innate immune and cytokine-related pathways, whereas tissue-level and single-cell analyses have provided additional insights into coronary artery inflammation and immune cell dynamics. Transcriptomic studies in KD are limited by cohort heterogeneity and technical variability. To address these challenges, integrative approaches such as cross-cohort meta-analysis and multi-omics validation have been adopted to improve robustness and enhance the reliability of findings. These integrative efforts hold promise for advancing transcriptomic research in KD toward clinically actionable applications, including improved diagnostic precision and risk stratification for coronary complications. This review provides an overview of recent advances in experimental and computational approaches in KD transcriptomics, evaluates analytical limitations, and discusses integrative strategies with potential clinical implications.