Collectively, our results uncovered a previously unknown function of rCsNOSIP in promoting CCA invasion and metastasis as well as a novel protective role of SIRT5/ ASPSCR1 against adverse stimulus, which partly support the acceptable theory that CsESPs induce the occurrence and progression of CCA through ROS/RNS-induced oxidative and nitrative DNA damage [34]. The gene discussed is ASPSCR1; the disease is cholangiocarcinoma.