The migration of lymphocytes into the CNS during viral encephalitis is hindered by the blood-brain barrier (BBB) such that most infiltrating cells remain localized to perivascular spaces. This sequestration of leukocytes away from the parenchyma is believed to protect the CNS from immunopathologic injury. Infections of the CNS with highly cytopathic neurotropic viruses, such as West Nile virus (WNV), however, require the parenchymal penetration of T lymphocytes for virus clearance and survival, suggesting that perivascular localization might hinder antiviral immune responses during WNV encephalitis. Using human and murine brain specimens from individuals with WNV encephalitis, we evaluated the expression of CXCL12 and its receptor, CXCR4, at the BBB and tested the hypothesis that inhibition of CXCR4 would promote T lymphocyte entry into the CNS parenchyma and increase viral clearance. Antagonism of CXCR4 significantly improved survival from lethal infection through enhanced intraparenchymal migration of WNV-specific CD8 ؉ T cells within the brain, leading to reduced viral loads and, surprisingly, decreased immunopathology at this site. The benefits of enhanced CD8 ؉ T cell infiltration suggest that pharmacologic targeting of CXCR4 may have therapeutic utility for the treatment of acute viral infections of the CNS.CD8 T cell ͉ CNS ͉ CXCL12 ͉ chemokine ͉ neuropathology U nder normal, uninflamed conditions, the CNS is an immuneprivileged site with minimal infiltration by inflammatory cells (1). The limited trafficking of leukocytes is the result of restriction at the blood-brain barrier (BBB); the specialized microvasculature of the CNS that prevents the entry of cells through mechanisms that are incompletely understood. Although immune cell restriction may protect the brain from inappropriate immune activation and neuropathology (2), it may also act as a barrier to successful pathogen clearance during acute infections of the CNS (3). Indeed, one of the hallmarks of viral encephalitis is the development of perivascular infiltrates comprised of virus-specific T cells with minimal invasion of the CNS parenchyma (4). Thus, BBB restriction may limit CNS antiviral immune responses at the expense of delayed clearance of microbial agents.Studies in mice suggest that polarized expression of the chemokine CXCL12 at the BBB localizes infiltrating mononuclear cells to the perivascular spaces of the CNS microvasculature, therefore limiting their entry into the CNS parenchyma (5). CXCL12 expression is present along the basolateral surfaces of CNS endothelial cells where leukocytes, which ubiquitously express its receptor CXCR4, engage CXCL12 when attempting to enter the CNS. This subcompartment retention, which is analogous to the role of CXCL12 in lymphoid compartments (6), could be an integral component of CNS protection from the pathologic consequences of immune cell activation (7). In CNS autoimmune diseases, such as multiple sclerosis (MS) and its murine model experimental autoimmune encephalomyelitis (EAE), alterations in...