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Abstract

The Duffy blood group system (FY) is one of the most therapeutically significant blood group systems due to its multiple roles in transfusion medicine, infectious disease susceptibility, and inflammatory control. The Duffy antigen receptor for chemokines (DARC) works as both a blood group antigen and a chemokine binding protein. DARC has been renamed by HUGO’s Gene Nomenclature Committee. ACKR1 is now the accepted term and is used extensively by NCBI and LRG. This comprehensive analysis investigates the molecular genetics, population biology, and clinical importance of the Duffy blood type system, with a focus on its well-established link to benign ethnic neutropenia (BEN). We explain the pathophysiological processes that link the Duffy null phenotype Fy(a-b-) to neutropenia and its clinical significance, including the "chemokine sink" concept and abnormal neutrophil homeostasis. The clinical implications for hematology, oncology, psychiatry, and general medicine are thoroughly reviewed, emphasizing the necessity of identifying BEN to avoid misdiagnosis and provide equal therapy. New research on the Duffy system's significance in cancer biology, transplant immunology, and inflammatory illnesses is also discussed. Understanding these complicated relationships is critical for clinicians and researchers dealing with ethnically diverse groups‎.

Keywords: Duffy blood group, DAR, ACKR1, Benign ethnic neutropenia, Plasmodium vivax, Chemokine receptor

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