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At the cellular level, E4 directly targets Mller cells to attenuate reactive gliosis, preserving the critical Bcl-2/Bax and Bcl-xL/Bax pro-survival ratios and consequently mitigating mitochondrial-mediated apoptosis via reduced caspase-3 activation [52]
Medication non-adherence or subtherapeutic dosing represents a possible explanation
The goal shifts to maximizing salvageable follicles and preventing further loss
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