Although the expression of Akt phosphorylation was increased in H2O2 treatment of CD44 silencing cells that might be involved with the imbalance of the redox status, the activation of Akt in CCA was regulated not only by the redox system, but also many other factors such as cytokines, growth factors, and bile acid [38]. This evidence concerns the gene AKT1 and cholangiocarcinoma.