From my understanding there wasn't any region protection for the CD based games and I remember trying some Japanese CDs in my TurboGrafx CD and TurboDuo about 10-15 years ago. I was surprised that they worked so well then!
I did some more research (or googling) and found a 3rd System Card v3.0 that is identified as being from Japan with an md5sum of 38179df8f4ac870017db21ebcbf53114. I tried Mirai Shounen Conan and Sylphia and they both worked on this BIOS. I also tried that 4 in 1 Super CD for the US Turbo Duo (this is the same one I had for my Duo which is also in storage lol) and it worked as well. The "System Card interface" looks just like ff1a674273fe3540ccef576376407d1d with "PC Engine" and "1991".
Also I was able to verify that the md5 of 0754f903b52e3b3342202bdafb13efa5 is indeed the USA version.
I updated the wiki with this:
https://github.com/RetroPie/RetroPie-Setup/wiki/PC-Engine
I ran out of time searching and didn't get to look up ff1a674273fe3540ccef576376407d1d to see if it was just another Japan or maybe Europe?