SOX9 and metabolic dysfunction-associated steatohepatitis: Senescent cholangiocytes have been observed in prolonged stages of PSC, PBC, NASH, and chronic viral hepatitis, where their SASP drives immune activation and periductular fibrosis [7, 9, 11, 12] Interestingly, the transient upregulation of SOX9 in senescent spheroids points to early ductular reactions and epithelial plasticity, features commonly seen in chronic cholangiopathies (Figure 4C).