The role of sulfatides in the biliary tree: from physiopathology to clinical application

This thesis explored the role of sulfatides in the bile ducts and their involvement in liver diseases such as primary sclerosing cholangitis (PSC) and cholangiocarcinoma (CCA). Using patient samples, cell lines, and organoids, the study found that higher sulfatide levels were linked to advanced liver fibrosis in PSC. In intrahepatic CCA, a higher proportion of unsaturated sulfatides was associated with a shorter time before the disease returned, suggesting possible use as a marker. The study also showed that the enzyme GAL3ST1, which produces sulfatides, affects how cancer cells grow and behave. When GAL3ST1 was reduced, cells used energy differently, strengthened their structure, and became less aggressive. Overall, the findings suggest that changes in sulfatides may help explain how these liver diseases develop and could point to new ways to diagnose or treat them.