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Background and Aims: CXCL5 (chemokine [C-X-C motif] ligand 5, also known as epithelial neutrophil-activating peptide 78 [ENA78]) belongs to the CXC chemokine family and has been shown to have promitotic effects on hepatocytes. The aim of our study was to assess CXCL5 plasma levels in patients with chronic liver disease., Methods: CXCL5 plasma levels were measured in 111 patients with chronic liver disease and 98 healthy controls. The gene expression of CXCL5 and its main receptor, CXC receptor-2, were also determined in liver biopsies from 46 patients., Results: CXCL5 levels were correlated with clinical presentation, laboratory parameters, and liver histology. Plasma CXCL5 levels in patients with liver cirrhosis were lower than those in healthy controls, and correlated with hepatic biosynthetic capacity, Child-Pugh and model for end-stage liver disease scores. Patients with hepatic necroinflammation and fibrosis on liver histology showed lower plasma CXCL5 levels. In patients with typical clinical complications of cirrhosis, CXCL5 levels were found to be decreased. Intrahepatically, CXCL5 expression was increased in patients with advanced fibrosis and cirrhosis. The isolation of different cellular compartments from mouse livers suggested that hepatic stellate cells and sinusoidal endothelial cells are the main sources of hepatic CXCL5., Conclusions: Plasma CXCL5 levels are lower in patients with chronic liver disease, suggesting that CXCL5 might be involved in the pathogenesis of chronic liver disease. CXCL5 could serve as an additional biomarker for hepatic necroinflammation and fibrosis., (© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.)