The Duffy antigen/receptor for chemokines (DARC) and prostate cancer. A role as clear as black and white?

Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death among men in the United States. African American men have a 60% greater incidence of prostate cancer and a twofold higher mortality rate than Caucasian men. The Duffy antigen/receptor for chemokines (DARC) is a receptor expressed on erythrocytes and vascular endothelial cells that binds to and clears angiogenic chemokines. The DARC also functions as the erythrocyte receptor for invasion by malarial parasites. Approximately 70% of African Americans lack erythrocyte expression of the DARC as a genetic mechanism of protection against malaria infection. Given the importance of angiogenic chemokines in the development of tumor vascular networks and the chemokine binding properties of the DARC, the possibility that a lack of DARC expression on erythrocytes may represent an epigenetic factor that predisposes African American men to a greater incidence and mortality of prostate cancer should be considered.