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PSC needs to be differentiated from others causes of sclerosing cholangitis, collectively known as secondary sclerosing cholangitis

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Biofilm growth is linked to the activation of highly conserved stress-response signaling cascades, primarily the heat shock protein (Hsp) network (Hsp90/Hsp70 and their co-chaperones), the calcineurin signaling pathway, and downstream gene expression responses, all of which help maintain protein folding, cell wall integrity, and ionic homeostasis under drug- and host-imposed stressors (Roy and Tamuli, 2022