Prenatal-lactational alcohol exposure induces sex-specific CX3CL1/CX3CR1 dysregulation linked to neuroendocrine imbalance and cardiovascular risk

• Prenatal-lactational alcohol exposure (PLAE) induces long-term, sex-specific dysregulation of the CX 3 CL1/CX 3 CR1 axis. • PLAE alters neurobehavioral, inflammatory, vascular, and cardiac gene expression markers • Female PLAE offspring show anxiety-like behavior, elevated CX 3 CL1, and cardiac Cx3cr1 expression. • CX 3 CL1 correlates with behavior anxiety-like and stress-coping, endocrine, immune, and cardiovascular outcomes. • Fractalkine emerges as a central integrative pathway linking behavioral, immune, and vascular dysfunctions. Fetal alcohol spectrum disorder is associated with lasting neurodevelopmental and cardiovascular dysfunctions. The fractalkine axis CX 3 CL1/CX 3 CR1, a chemokine and its sole known receptor expressed in microglia and myeloid/endothelial cells, coordinates neuroimmune and vascular responses. We tested whether prenatal-lactational alcohol exposure (PLAE) is associated with sex-specific dysregulation of this axis along with integrated behavioral, neuroendocrine, inflammatory, and cardiovascular signatures. Pregnant C57BL/6 dams consumed 20% ethanol using a drinking-in-the-dark (DID) paradigm throughout gestation and lactation. Adult offspring (PND60–70) underwent behavioral testing (elevated plus maze and tail suspension test); plasma profiling of corticosterone, cytokines/chemokines, endothelial/coagulation markers, and matrix-remodeling enzymes; and cardiac transcriptional assays for stress- and inflammation-related genes (including Cx3cr1 ). Analyses were stratified by sex. PLAE females exhibited increased anxiety-like behavior, two-fold higher plasma CX 3 CL1, and upregulated cardiac Cx3cr1 compared with control females. PLAE males showed no behavioral or endocrine changes but evidence of matrix remodeling (elevated proMMP-9, reduced sP-Selectin). Across sexes, PLAE was associated with a proinflammatory/endothelial-activation profile (elevated IL13, IL18, and PAI-1, reduced CXCL16, higher proMMP-9) and altered cardiac expression of Nr3c2 , Tnfrsf1a , Tlr4 , and Nfkbia , compatible with early vascular risk. Independent of exposure, females exhibited reduced immobility and higher corticosterone, IL5, IL13, sE-Selectin, and thrombomodulin. Plasma CX 3 CL1 correlated inversely with exploratory and stress-coping behaviors, and positively with corticosterone, inflammatory/vascular markers, and cardiac Cx3cr1 and Tnfrsf1a . PLAE is associated with sex-specific dysregulation of the CX 3 CL1/CX 3 CR1 axis and convergent neuroimmune-vascular signatures indicative of subclinical endothelial dysfunction. These associative findings support the hypothesis that fractalkine-pathway modulation may mitigate long-term neurobehavioral and cardiovascular vulnerability after PLAE, warranting causal testing.