Six pathways, namely the set of genes upregulated with PSMD4 and the KEGG pathways of type I diabetes mellitus, graft-versus-host disease, allograft rejection, antigen processing and presentation, and viral myocarditis, were significantly (p-values: RE_p ≤ 4.86E − 06 or Bin_pA ≤ 0.05) associated with PAR-dr and WL-dr in discovery cohorts (Table 2). Here, PSMD4 is linked to viral myocarditis.