Integrative systems neuroimmunology reveals leukocyte-expressing PAX6 as a critical predictor of major depressive disorder

Major depressive disorder (MDD) is a complex psychiatric condition with a significant global impact. This study applied a genomic-driven integrative systems neuroimmunology approach to analyze transcriptomic data from 3,114 individuals (1,877 MDD patients and 1,237 controls). The analysis revealed neuroimmunological transcriptomic alterations, indicating cross-talk between the immune and nervous systems in peripheral blood mononuclear cells (PBMCs) and specific brain regions. Among 31 shared genes, NEGR1, PPP6C, SORCS3, and PAX6 emerged as significant predictors of MDD in patients’ PBMCs. Notably, PAX6 was also identified as a differentially expressed gene (DEG) in the amygdala, while NEGR1, PPP6C, and SORCS3 showed no significant differential expression in other central nervous system (CNS) regions. Validation by immunophenotyping in a mouse model of chronic stress demonstrated increased PAX6 expression in PBMCs, a gene previously associated with MDD in GWAS studies. Collectively, our findings suggest the existence of shared transcriptomic modules across the brain and immune system, highlighting PAX6 as a potential therapeutic target in MDD.