CX3CL1 (Fractalkine) is a unique chemokine with dual chemotactic and adhesive functions that exists in both membrane-bound and soluble forms 1. It is produced by neurons, endothelial cells, hepatocytes, and epithelial cells, signaling primarily through its sole receptor CX3CR1 on immune cells including microglia, monocytes, macrophages, NK cells, and T cells 12. The CX3CL1-CX3CR1 axis activates MAPK and AKT signaling pathways 2, with downstream effects including leukocyte recruitment and activation. In the central nervous system, CX3CL1 primarily exerts neuroprotective effects by reducing proinflammatory microglial responses, making it a therapeutic target for neurodegenerative diseases 1. In cancer, CX3CL1 plays a complex dual role: it recruits antitumoral immune cells (NK cells and T cells) to suppress tumor growth, yet also facilitates immune suppression through regulatory T cell enhancement and supports angiogenesis and metastasis 34. In kidney disease, CX3CL1 produced by renal endothelium and tubular epithelium promotes leukocyte attraction and is upregulated across multiple inflammatory conditions 5. Increased CX3CL1/CX3CR1 expression correlates with atherosclerotic plaque severity and is associated with coronary artery disease susceptibility 6. Additionally, CX3CL1 mediates cytoadherence of P. falciparum-infected erythrocytes and plays roles in pregnancy-related immune tolerance 7.