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In vivo , the sperm-zona pellucida binding triggers a cascade of signal transduction reactions that culminates in an significant increase in intracellular Ca 2+ levels required for acrosomal exocytosis (83)

Analysis of transcription factor activities revealed significant effects on immune regulation

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Activation of Mania/Hypomania Advise patients, their families and caregivers to observe for signs of activation of mania/hypomania and instruct them to report such symptoms to the healthcare provider [see Warnings and Precautions (5.6)]