| الملخص: | Abstract Background Viral myocarditis (VMC) primarily affects children and adolescents, with a certain risk of mortality. Its clinical manifestations are complex and variable, making early diagnosis difficult. Therefore, there is an urgent need to identify effective biomarkers. Methods This study collected clinical data from 110 children with VMC and 100 healthy children. The expression levels of SOX2-OT and miR-27b-3p in cells and serum were assessed by RT-qPCR. The diagnostic and prognostic values of these markers were evaluated through ROC curve analysis and logistic regression. ELISA was used to assess the levels of inflammatory cytokines TNF-α, IL-6, and IL-1β. Commercial kits quantified serum LDH, CK-MB, and cTnI levels. The interaction between SOX2-OT and miR-27b-3p was validated by dual-luciferase reporter and RIP assays. Results Serum SOX2-OT was elevated and miR-27b-3p was decreased in VMC patients, and the combination of the two showed excellent diagnostic performance. Serum SOX2-OT and miR-27b-3p were strongly correlated with disease severity. In patients with poorer prognosis, SOX2-OT was significantly higher, and miR-27b-3p lower; their combined assessment also predicted prognosis effectively. Mechanistically, SOX2-OT acted as a “sponge” to inhibit miR-27b-3p, promoting inflammation and cardiomyocyte injury in vitro. Conclusions Elevated serum SOX2-OT and decreased miR-27b-3p serve as potential biomarkers for early diagnosis and prognosis in VMC. Their combined detection greatly improves accuracy. The SOX2-OT/miR-27b-3p axis plays a key role in VMC pathogenesis by modulating inflammation and myocardial injury, providing a promising molecular target for future therapeutic interventions.
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