DNA examination of ancient dental pulp incriminates typhoid fever as a probable cause of the Plague of Athens

Immuno-PCR--a new tool for paleomicrobiology: the plague paradigm

BACKGROUND

The cause of past plague pandemics was controversial but several research teams used PCR techniques and dental pulp as the primary material to reveal that they were caused by Yersinia pestis. However, the degradation of DNA limits the ability to detect ancient infections.

METHODS

We used for the first time immuno-PCR to detect Yersinia pestis antigens; it can detect protein concentrations 70 times lower than the standard ELISA. After determining the cut-off value, we tested 34 teeth that were obtained from mass graves of plague, and compared previous PCR results with ELISA and immuno-PCR results.

RESULTS

The immuno-PCR technique was the most sensitive (14 out of 34) followed by the PCR technique (10 out of 34) and ELISA (3 out of 34). The combination of these three methods identified 18 out of 34 (53%) teeth as presumably being from people with the plague.

CONCLUSION

Immuno-PCR is specific (no false-positive samples were found) and more sensitive than the currently used method to detect antigens of ancient infections in dental pulp. The combination of three methods, ELISA, PCR and immuno-PCR, increased the capacity to identify ancient pathogens in dental pulp.

Salmonella infections: an update on epidemiology, management, and prevention

Salmonella species are a group of Gram-negative enterobacteria and known human pathogens in developing as well as industrialized countries. Despite significant advances in sanitation, provision of potable water, and highly controlled food chain surveillance, transmission of Salmonella spp. continues to affect communities, preferentially children, worldwide. This review summarizes updated concepts on typhoidal and non-typhoidal Salmonella infections, starting with a historical perspective that implicates typhoid Salmonella as a significant human pathogen since ancient times. We describe the epidemiology of this pathogen with emphasis on the most recent non-typhoidal Salmonella outbreaks in industrialized countries and continued outbreaks of typhoid Salmonella in underserved countries. An overview of clinical aspects of typhoid and non-typhoid infections in developing and industrialized countries, respectively, is provided, followed by a description on current treatment concepts and challenges treating multidrug-resistant Salmonella infections. We conclude with prevention recommendations, and recent research studies on vaccine prevention.

Prior Helicobacter pylori infection ameliorates Salmonella typhimurium-induced colitis: mucosal crosstalk between stomach and distal intestine

BACKGROUND

Helicobacter pylori infection is associated with a lower risk of chronic autoimmune diseases including inflammatory bowel disease (IBD). H.pylori modulates the gastric immune response, decreasing the local inflammatory response to itself. In mice, chronic Salmonellatyphimurium infection induces colitis similar to Crohn's disease, characterized by inflammation, which progresses toward fibrosis. The aim of this study was to determine whether prior H. pylori infection acts at a distance to modulate the immune response of S.typhimurium-induced colitis.

METHODS

Mice were infected with the mouse-adapted strain of H. pylori (SS1), followed by infection with S.typhimurium. The effect of H. pylori on colitis was determined by gross pathology, histopathology, cytokine response, and development of fibrosis in the cecum. Gastritis and systemic immune response was measured in response to infection.

RESULTS

H.pylori suppresses the Th17 response to S.typhimurium infection in the mouse cecum, but does not alter the Th2 or T-regulatory response or the development of fibrosis. H. pylori infection induces IL-10 in the mesenteric lymph nodes, suggesting an extragastric mechanism for immunomodulation. H. pylori / S.typhimurium coinfection decreases inflammation in both the cecum and the stomach.

CONCLUSIONS

This study demonstrates a potential mechanism for the negative association between H. pylori and IBD in humans. H. pylori represses the lower gastrointestinal tract Th17 response to bacterially induced colitis via extragastric immunomodulatory effects, illustrating immunological crosstalk between the upper and lower gastrointestinal tract.

Facial reconstruction of an 11-year-old female resident of 430 BC Athens

Although modern standards of ideal proportions and facial esthetics are based mostly on observations of human faces as depicted in Classical Greek masterpieces of art, the real faces of ordinary ancient Greeks have, until now, remained elusive and subject to the imagination. Objective forensic techniques of facial reconstruction have never been applied before, because human skeletal material from Classical Greece has been extremely scarce, since most decent burials of that time required cremation. Here, the authors show stage by stage the facial reconstruction of an 11-year-old girl whose skull was unearthed in excellent condition from a mass grave with victims of the Plague that struck Athens of 430 bc. The original skull was replicated via three-dimensional modeling and rapid prototyping techniques. The reconstruction followed the Manchester method, laying the facial tissues from the surface of the skull outward by using depth-marker pegs as thickness guides. The shape, size, and position of the eyes, ears, nose, and mouth were determined according to features of the underlying skeletal tissues, whereas the hairstyle followed the fashion of the time. This is the first case of facial reconstruction of a layperson residing in Athens of the Golden Age of Pericles. It is ironic, however, that this unfortunate girl who lived such a short life in ancient Athens, will now, 2500 years later, have the chance to travel and be universally recognizable in a world much bigger than anybody in ancient Athens could have ever imagined.

Humans and evolutionary and ecological forces shaped the phylogeography of recently emerged diseases

The development of human civilizations and global commerce has led to the emergence and worldwide circulation of many infectious diseases. Anthrax, plague and tularaemia are three zoonotic diseases that have been intensely studied through genome characterization of the causative species and phylogeographical analyses. A few highly fit genotypes in each species represent the causative agents for most of the observed disease cases. Together, mutational and selective forces create highly adapted pathogens, but this must be coupled with ecological opportunities for global expansion. This Review describes the distributions of the bacteria that cause anthrax, plague and tularaemia and investigates the forces that created clonal structures in these species.

Evolution, population structure, and phylogeography of genetically monomorphic bacterial pathogens

Genetically monomorphic bacteria contain so little sequence diversity that sequencing a few gene fragments yields little or no information. As a result, our understanding of their evolutionary patterns presents greater technical challenges than exist for genetically diverse microbes. These challenges are now being met by analyses at the genomic level for diverse types of genetic variation, the most promising of which are single nucleotide polymorphisms. Many of the most virulent bacterial pathogens are genetically monomorphic, and understanding their evolutionary and phylogeographic patterns will help our understanding of the effects of infectious disease on human history.

Dental status and orthodontic treatment needs of an 11-year-old female resident of Athens, 430 BC

This report presents the skeletal and dental features of "Myrtis", an 11-year-old female resident of ancient Athens back in 430 BC. Her skeleton was unearthed in an archaeological excavation of a mass burial pit located in the outskirts of Kerameikos' ancient cemetery of Athens. "Myrtis" is believed to have been one of the numerous hapless victims of the Plague of Athens. Her skull was found in relatively intact condition bearing her complete dentition corresponding to the mixed dentition stage. A complete dental and orthodontic diagnosis of Myrtis was conducted based on clinical examination, study of panoramic radiographs, and lateral cephalometric analysis of her skull. No significant dental pathology was reported pertaining to deciduous or permanent teeth of "Myrtis". A Class II skeletal and dental malocclusion was observed. The ectopic labial eruption of the maxillary canines mesially to their retained deciduous predecessors, the ectopic distally directed eruption of a lower first premolar, and a unilaterally missing lower third molar were among the most interesting dental findings reported.

A new method to extract dental pulp DNA: application to universal detection of bacteria

Background

Dental pulp is used for PCR-based detection of DNA derived from host and bacteremic microorganims. Current protocols require odontology expertise for proper recovery of the dental pulp. Dental pulp specimen exposed to laboratory environment yields contaminants detected using universal 16S rDNA-based detection of bacteria.

Methodology/Principal Findings

We developed a new protocol by encasing decontaminated tooth into sterile resin, extracting DNA into the dental pulp chamber itself and decontaminating PCR reagents by filtration and double restriction enzyme digestion. Application to 16S rDNA-based detection of bacteria in 144 teeth collected in 86 healthy people yielded a unique sequence in only 14 teeth (9.7%) from 12 individuals (14%). Each individual yielded a unique 16S rDNA sequence in 1–2 teeth per individual. Negative controls remained negative. Bacterial identifications were all confirmed by amplification and sequencing of specific rpoB sequence.

Conclusions/Significance

The new protocol prevented laboratory contamination of the dental pulp. It allowed the detection of bacteria responsible for dental pulp colonization from blood and periodontal tissue. Only 10% such samples contained 16S rDNA. It provides a new tool for the retrospective diagnostic of bacteremia by allowing the universal detection of bacterial DNA in animal and human, contemporary or ancient tooth. It could be further applied to identification of host DNA in forensic medicine and anthropology.

On the origin of smallpox: correlating variola phylogenics with historical smallpox records

Human disease likely attributable to variola virus (VARV), the etiologic agent of smallpox, has been reported in human populations for >2,000 years. VARV is unique among orthopoxviruses in that it is an exclusively human pathogen. Because VARV has a large, slowly evolving DNA genome, we were able to construct a robust phylogeny of VARV by analyzing concatenated single nucleotide polymorphisms (SNPs) from genome sequences of 47 VARV isolates with broad geographic distributions. Our results show two primary VARV clades, which likely diverged from an ancestral African rodent-borne variola-like virus either approximately 16,000 or approximately 68,000 years before present (YBP), depending on which historical records (East Asian or African) are used to calibrate the molecular clock. One primary clade was represented by the Asian VARV major strains, the more clinically severe form of smallpox, which spread from Asia either 400 or 1,600 YBP. Another primary clade included both alastrim minor, a phenotypically mild smallpox described from the American continents, and isolates from West Africa. This clade diverged from an ancestral VARV either 1,400 or 6,300 YBP, and then further diverged into two subclades at least 800 YBP. All of these analyses indicate that the divergence of alastrim and variola major occurred earlier than previously believed.

Manipulation of human history by microbes

The convergence of the microbial and human worlds provides us with everyday essentials for the survival of our species, and in turn, this interaction brings painful and tragic consequences from pathogens. Looking back, it can be seen that microbes have also changed our history. Were it not for a pathogen that halted an Assyrian military campaign, we might have no Judaism, Christianity, or Islam. Microbes were there to aid adversaries in bringing about the fall of the great Greek and Roman empires. George Washington's bold orders to inoculate the Colonial Army against smallpox (20 years prior to Jenner's discovery of vaccination) were one of the most significant actions in saving the American Revolution from an early and unsuccessful end. Without the yellow fever virus and its accomplice, Aedes aegypti, those living in what was the Louisiana Territory might now have French as their native language. The potato blight caused by Phytophthora infestans changed the histories of both Ireland and those countries (especially the United States) to which victims of the famine emigrated. At the outbreak of World War I, when England was separated from its European source of acetone (needed for the navy's supply of cordite), British citizens had to make do with less gin, but acetone was available thanks to the growth of Clostridium acetobutylicum in those fermentation vessels.

Ancient typhoid epidemic reveals possible ancestral strain of Salmonella enterica serovar Typhi

In contrast to other serotypes of Salmonella enterica, S. Typhi is exclusively adapted to human hosts. Recently, S. Typhi was identified in ancient skeletal material, thereby incriminating typhoid fever for the Plague of Athens. Since, according to Thucydides' report, animals were also affected by the disease, a working hypothesis is constituted that the causative agent of the Plague might be the anticipated original strain of S. Typhi, purportedly capable of infecting animals as well as humans. Possible future sequencing of the discovered ancient strain of S. Typhi may help towards identifying its genomic differences responsible for its modern specification to humans.