IntroductionChemokines comprise a family of about 50 small protein ligands that together with their cognate receptors control leukocyte trafficking during immune surveillance and inflammatory-cell recruitment during host defense. [1][2][3] Besides their known function in the immune system, these molecules have also been implicated in the maintenance of central nervous system (CNS) homeostasis and as a mediator of neuroinflammation. [4][5][6][7][8] Two types of interactions primarily control the activity of chemokines in the CNS. The first involves chemokine immobilization by glycosaminoglycans (GAGs), which play a role in the formation of chemokine gradients and trigger localization of leukocyte subpopulations to the site of infection or injury, present at the endothelial surface and the extracellular matrix. 9,10 The other interaction entails the tight binding of chemokines to their G-protein-coupled receptors on the surface of leukocytes; this binding activates integrins and promotes their adhesion to the endothelium, followed by their penetration across the endothelial layer into the CNS perivascular space. [11][12][13][14][15] In the CNS, chemokines are expressed constitutively at low or negligible levels in astrocytes and microglia, but their expression is rapidly induced by neuroinflammatory conditions [16][17][18] and is mediated by several proinflammatory cytokines (eg, tumor necrosis factor ␣ [TNF-␣], interferon ␥ [IFN-␥], and tumor growth factor 1 [TGF-1]). [19][20][21][22] CNS inflammation occurs in several neurodegenerative conditions, including those associated with a lysosomal storage disease (LSD), [23][24] and is likely responsible for the recruitment of monocytes and macrophages from peripheral blood. In the murine model of the LSD, G M2 -gangliosidosis recruitment of macrophages into the CNS is mediated by the chemokine macrophage inflammatory protein 1-␣ (MIP-1␣) and has been implicated in the pathogenesis of this disease. 25 Genetic defects that alter -galactosidase (-gal) activity in humans have a devastating effect on the CNS and result in the neurodegenerative LSD G M1 -gangliosidosis. 26 The clinical phenotypes of this disease demonstrate a continuum of severity: (1) Infantile G M1 -gangliosidosis progresses rapidly; developmental arrest occurs soon after birth; and symptoms include profound neurologic deterioration, psychomotor retardation, visceromegaly, and cardiac involvement. Death due to infection or cardiac failure occurs normally within the second year of life. (2) Late-infantile/ juvenile G M1 -gangliosidosis includes little or no systemic organ involvement, but neurologic problems, ataxia, and seizures develop generally soon after the onset of the symptoms. (3) Chronic G M1 -gangliosidosis manifests as slow, progressive dementia, Parkinsonian features, and extrapyramidal signs. At the cellular level, G M1 -gangliosidosis affects primarily neurons, which become distended and fill with membranous cytoplasmic bodies, but astrocytes and microglia also appear vacuolated. Abnormal...