Given the expression of CCR2, CCR1 and CCR5 by hepatic monocytes/macrophages, the local upregulation of ccl2 and ccl5 in the whole liver and the systemic elevation of CCL3 (healthy controls compared to CLD patients, p = 0.0387) and CCL4 (healthy controls compared to CLD patients, p = 0.0064) in the circulation, we speculated that peripheral blood monocytes in patients might regulate their chemokine receptor expression, rendering them more prone to accumulate in the diseased liver. The gene discussed is CCL4; the disease is congenital secretory chloride diarrhea 1.