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INTRODUCTION: A 1-year-old Malay girl presented with pallor, failure to thrive and hepatosplenomegaly. Her blood was sent for thalassaemia screening and it was incidentally found that her blood appeared lipaemic. CASE REPORT: Primary and secondary causes of hyperlipidaemia were investigated. Her blood was sent for fasting lipid profile, thyroid function test (TFT), fasting plasma glucose (FPG), liver function test (LFT), renal profile (RP) and HIV screening. Lipaemic interference was removed by high-speed centrifugation. She is a product of non-consanguineous marriage. She is staying together with her stepfather who is HIV positive. Her mother's infective status was negative with no dyslipidaemic features and a normal lipid profile. Lipid profile of her biological father was not known. No other lipid stigmata such as eruptive xanthoma or lipaemia retinalis was seen in the patient. Haemoglobin analysis showed Hb E-Beta thalassaemia major. Her triglycerides was 9.05 mmol/L with normal total cholesterol, 2.85 mmol/L and high-density lipoprotein cholesterol (HDL-c), 0.26 mmol/L. Calculated low-density lipoprotein cholesterol (LDL-c) was invalid as triglycerides was >4.5 mmol/L. TFT, RP, FPG, LFT were normal and HIV status was negative. She was transfused with 10 ml/kg packed cell and her blood post transfusion appeared non lipaemic. CONCLUSION: Primary hypertriglyceridaemia was excluded based on insignificant family history of dyslipidaemia. Secondary causes of hypertriglyceridaemia were ruled out based on unremarkable laboratory investigations. Thus, we conclude that this patient is having hypertriglyceridaemia thalassaemia syndrome (HTS) which is a rare disorder with unknown pathogenesis. Further research may be required to explore this unknown association.
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OBJECTIVE: The aim of this study was to evaluate the therapeutic effect of Smilacis Glabrae Rhixoma (SGR) on osteoporosis at the level of network pharmacology, and to find new targets and mechanisms of SGR in the treatment of osteoporosis, to better find new drugs and their clinical applications. MATERIALS AND METHODS: In the original network pharmacology mode, we used an improved mode, such as screening the ingredients and targets of SGR through tools such as GEO database, Autodock Vina, and GROMACS. Through molecular docking, we conducted further screening for the targets acting on the effective ingredients of SGR, and finally we performed molecular dynamics simulation and consulted a large amount of related literature for the validation of the results. RESULTS: By screening and validating the data, we finally confirmed that there were mainly 10 active ingredients in SGR, which were isoeruboside b, smilagenin, diosgenin, stigmasterol, beta-sitosterol, sodium taurocholate, sitogluside, 4,7-dihydroxy-5-methoxy-6-methyl-8-formyl-flavan, simiglaside B, and simiglaside E, and mainly acted on eleven targets. These targets mainly exert therapeutic effects on osteoporosis by regulating 20 signaling pathways including Th17 cell differentiation, HIF-1 signaling pathway, apoptosis, inflammatory bowel disease, and osteoclast differentiation. CONCLUSIONS: Our study successfully explains the effective mechanism by which SGR ameliorates osteoporosis while predicting the potential targets NFKB1 and CTSK of SGR for the treatment of osteoporosis, which provides a novel basis for investigating the mechanism of action of new Traditional Chinese medicines (TCMs) at the network pharmacology level and a great support for subsequent studies on osteoporosis.