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Giuffra V, Minozzi S, Aringhieri G, Campana S, Riccomi G. A case of secondary hypertrophic osteoarthropathy from medieval Tuscany (central Italy, 10th-12th centuries CE). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 43:51-57. [PMID: 37742426 DOI: 10.1016/j.ijpp.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES This study aims to provide a detailed evaluation of a case of secondary hypertrophic osteoarthropathy (HOA) and to explore insights into the presence and consequences of disease in medieval rural Italy. MATERIALS The skeleton of a male (US 4405) with an estimated age at death of 51-69 years excavated from the medieval rural site of Pieve di Pava (Siena, Italy). METHODS Macroscopic and radiological (x-ray, CT) analyses were performed. RESULTS Symmetrical extensive periosteal new bone formation on the diaphyseal and metaphyseal regions of this individual's long bones; the lower limbs were more extensively and severely affected than the upper limbs and the distal segments were more severely altered in comparison to the proximal ones. CONCLUSIONS The macroscopic and radiological features are highly consistent with a diagnosis of secondary HOA. SIGNIFICANCE The excellent state of preservation allowed the evaluation of rarely noted skeletal manifestations of HOA and provided insight into aspects of rural life in medieval Italy. LIMITATIONS Molecular analysis was not successful in sequencing the aDNA of tuberculosis, therefore the underlying primary cause of secondary HOA, whether pulmonary or extrapulmonary, remains obscure in this case. SUGGESTION FOR THE FUTURE RESEARCH It is advisable to regularly revisit the data available from osteoarchaeological collections in order to identify further cases of HOA, along with to further investigate the known cases to search for the underlying primary disease.
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Affiliation(s)
- Valentina Giuffra
- Division of Paleopathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy.
| | - Simona Minozzi
- Division of Paleopathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Giacomo Aringhieri
- Division of Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
| | - Stefano Campana
- Department of History and Cultural Heritage, University of Siena, Italy
| | - Giulia Riccomi
- Division of Paleopathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Italy
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Turner MD. Possible Causes of Hypertrophic Osteoarthropathy in the La Ferrassie 1 Neanderthal. Cureus 2023; 15:e35721. [PMID: 37016656 PMCID: PMC10066876 DOI: 10.7759/cureus.35721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
For over a century, researchers have been perplexed by the unique osteological findings on La Ferrassie 1 (LF1), one of the most complete Neanderthal remains ever found. In 1997, Fennel and Trinkaus proposed that LF1 suffered from hypertrophic osteoarthropathy (HOA), likely secondary to chronic thoracic infection or pulmonary malignancy. This disease process can have many etiologies, and no study has fully explored the possible origin of LF1's HOA. Ultimately, it is most likely that LF1's HOA etiology arose from one of the many infectious diseases that prehistoric Neanderthals were exposed to, specifically a chronic pulmonary RNA virus.
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Gao ZR, Liu Q, Zhao J, Zhao YQ, Tan L, Zhang SH, Zhou YH, Chen Y, Guo Y, Feng YZ. A comprehensive analysis of the circRNA-miRNA-mRNA network in osteocyte-like cell associated with Mycobacterium leprae infection. PLoS Negl Trop Dis 2022; 16:e0010379. [PMID: 35500036 PMCID: PMC9098081 DOI: 10.1371/journal.pntd.0010379] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 05/12/2022] [Accepted: 03/31/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Bone formation and loss are the characteristic clinical manifestations of leprosy, but the mechanisms underlying the bone remodeling with Mycobacterium leprae (M. leprae) infection are unclear. METHODOLOGY/PRINCIPAL FINDINGS Osteocytes may have a role through regulating the differentiation of osteogenic lineages. To investigate osteocyte-related mechanisms in leprosy, we treated osteocyte-like cell with N-glycosylated muramyl dipeptide (N.g MDP). RNA-seq analysis showed 724 differentially expressed messenger RNAs (mRNAs) and 724 differentially expressed circular RNA (circRNAs). Of these, we filtered through eight osteogenic-related differentially expressed genes, according to the characteristic of competing endogenous RNA, PubMed databases, and bioinformatic analysis, including TargetScan, Gene Ontology, and Kyoto Encyclopedia of Genes and Genomes. Based on these results, we built a circRNA-microRNA (miRNA)-mRNA triple network. Quantitative reverse-transcription polymerase chain reaction and western blots analyses confirmed decreased Clock expression in osteocyte-like cell, while increased in bone mesenchymal stem cells (BMSCs), implicating a crucial factor in osteogenic differentiation. Immunohistochemistry showed obviously increased expression of CLOCK protein in BMSCs and osteoblasts in N.g MDP-treated mice, but decreased expression in osteocytes. CONCLUSIONS/SIGNIFICANCE This analytical method provided a basis for the relationship between N.g MDP and remodeling in osteocytes, and the circRNA-miRNA-mRNA triple network may offer a new target for leprosy therapeutics.
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Affiliation(s)
- Zheng-Rong Gao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiong Liu
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jie Zhao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ya-Qiong Zhao
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Li Tan
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shao-Hui Zhang
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ying-Hui Zhou
- National Clinical Research Center for Metabolic Diseases, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yun Chen
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yue Guo
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yun-Zhi Feng
- Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Loyer J, Murphy E, Ruppe M, Moiseyev V, Khartanovich V, Zammit J, Rottier S, Potrakhov N, Bessonov V, Obodovskiy A. Co-morbidity with hypertrophic osteoarthropathy: A possible Iron Age Sarmatian case from the Volga steppe of Russia. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 24:66-78. [PMID: 30296644 DOI: 10.1016/j.ijpp.2018.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 09/20/2018] [Accepted: 09/21/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Hypertrophic osteoarthropathy (HOA) is a condition that can be inherited or acquired. It causes diffuse periosteal new bone formation on the long bones, with a predilection for the appendicular skeleton. When acquired, it is a nonspecific indicator of systemic disease that arises following a primary condition. This paper reviews the palaeopathological literature associated with this rare condition. It also describes the first possible case of co-morbidity associated with hypertrophic osteoarthropathy in an adult skeleton (cal. BC 170 - 1 cal. AD) from the mobile pastoralist Sarmatian culture of the Volga steppes of Russia. METHODS Macroscopic and radiological examination provide differential diagnoses of the lesions, while clinical and bioarchaeological analyses offer insights into the possible experience of disease and social implications of care among the nomadic populations of Iron Age Russia. RESULTS The analysis of Sk. 6524.102 displays lesions that may be due to both hypertrophic osteoarthropathy and osteomalacia. The man was physically impaired and his participation in physically challenging activities would have been limited. CONCLUSIONS The study stresses that co-morbidity is a key parameter when interpreting disease in past populations, particularly when the diagnosis involves hypertrophic osteoarthropathy. SIGNIFICANCE This is the first case of hypertrophic osteoarthropathy identified in Eurasian prehistoric populations. The research emphasises the significance of co-morbidity in the past. LIMITATIONS The diagnosis of co-morbid diseases in human remains is extremely complex and the conditions were identified as most probable by a process of elimination. SUGGESTIONS FOR FURTHER RESEARCH Further studies should be dedicated to understanding co-morbidity in the past.
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Affiliation(s)
- Jeanna Loyer
- Archaeology and Palaeoecology, School of Natural and Built Environment, Queen's University Belfast, Belfast, BT7 1NN, Northern Ireland, UK.
| | - Eileen Murphy
- Archaeology and Palaeoecology, School of Natural and Built Environment, Queen's University Belfast, Belfast, BT7 1NN, Northern Ireland, UK.
| | - Mary Ruppe
- Department of Medicine, Division of Endocrinology, Houston Methodist hospital, Houston, TX, 77030, United States.
| | - Vyacheslav Moiseyev
- Department of Physical Anthropology, Kunstkamera Museum, 24 Sredniy Prospekt, Vasilievsky Island St. Petersburg, Russia.
| | - Valery Khartanovich
- Department of Physical Anthropology, Kunstkamera Museum, 24 Sredniy Prospekt, Vasilievsky Island St. Petersburg, Russia.
| | - Jean Zammit
- TRACES UMR 5608 and ISTHIA, CNRS/EHESS, Université Toulouse Jean Jaurès, Maison de la Recherche 5, allée Antonio MACHADO 31058 Toulouse, Cedex 9, France.
| | - Stephane Rottier
- UMR 5199 PACEA, Université de Bordeaux, Bâtiment B8, Allée Geoffroy Saint Hilaire CS, 50023 33615 PESSAC CEDEX, France.
| | - Nikolay Potrakhov
- Department of Electronic Devices, St. Petersburg State Electrotechnical University «LETI», 5 Professora Popova street, St. Petersburg, Russia.
| | - Victor Bessonov
- Department of Electronic Devices, St. Petersburg State Electrotechnical University «LETI», 5 Professora Popova street, St. Petersburg, Russia.
| | - Anatoliy Obodovskiy
- Department of Electronic Devices, St. Petersburg State Electrotechnical University «LETI», 5 Professora Popova street, St. Petersburg, Russia.
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Flohr S, Jasch I, Langer A, Riesenberg M, Hahn J, Wisotzki A, Kierdorf H, Kierdorf U, Wahl J. Secondary hypertrophic osteoarthropathy in a male from the Early Medieval settlement of Lauchheim, Germany. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 20:72-79. [PMID: 29496219 DOI: 10.1016/j.ijpp.2017.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/23/2017] [Accepted: 10/27/2017] [Indexed: 06/08/2023]
Abstract
Hypertrophic osteoarthropathy (HOA) is rarely diagnosed in archaeological human skeletons. Here, we report on the well-preserved skeleton of a middle-adult man from the early Medieval settlement site of Lauchheim (Germany) that exhibits pronounced multi-layered shell-like periosteal new bone formation in a bilaterally symmetric fashion on the long bones, the skeletal elements of the pelvis and those of the pectoral girdle. In addition, the two distal phalanges recovered show signs of osteoclastic resorption on their distal tuberosities. The distribution and morphology of the observed lesions are consistent with a diagnosis of HOA. The adult age at death of the individual and the co-occurrence of "healed" and "active" lesions suggest a secondary form of HOA. Given that only skeletal remains were available for study, the underlying (pulmonary or non-pulmonary) primary disease cannot be definitively ascertained in the present case. No osseous changes were found on the ribs, but signs of osteoclastic resorption were observed on the dorsal surface of the sternal body, which might indicate a retrosternal or mediastinal location of the primary disease. Thus far, only a few archaeological case studies of secondary HOA reported signs of the presumed underlying primary disease, which was of a pulmonary nature in each of the individuals.
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Affiliation(s)
- Stefan Flohr
- University of Hildesheim, Department of Biology, Universitätsplatz 1, 31141, Hildesheim, Germany.
| | - Isabelle Jasch
- Eberhard Karls University Tübingen, Institute of Prehistory, Early History and Medieval Studies, Schloss Hohentübingen, Burgsteige 11, 72070, Tübingen, Germany
| | - Antje Langer
- Eberhard Karls University Tübingen, Institute of Prehistory, Early History and Medieval Studies, Schloss Hohentübingen, Burgsteige 11, 72070, Tübingen, Germany
| | - Martin Riesenberg
- Free University of Berlin, Institute of Prehistoric Archaeology, Fabeckstraße 23-25, 14195, Berlin, Germany
| | - Julia Hahn
- Eberhard Karls University Tübingen, Institute of Prehistory, Early History and Medieval Studies, Schloss Hohentübingen, Burgsteige 11, 72070, Tübingen, Germany
| | - Axel Wisotzki
- St Bernward's Hospital, Radiological Department, Treibestraße 9, 31134 Hildesheim, Germany
| | - Horst Kierdorf
- University of Hildesheim, Department of Biology, Universitätsplatz 1, 31141, Hildesheim, Germany
| | - Uwe Kierdorf
- University of Hildesheim, Department of Biology, Universitätsplatz 1, 31141, Hildesheim, Germany
| | - Joachim Wahl
- Landesamt für Denkmalpflege im Regierungspräsidium Stuttgart, Stromeyersdorfstraße 3, 78467, Konstanz, Germany; Eberhard Karls University Tübingen, Institute for Archaeological Science, Rümelinstraße 23, 72070, Tübingen, Germany
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Binder M, Saad M. Hypertrophic osteoarthropathy in a young adult male from Berber, Sudan (2nd-3rd century CE). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2017; 18:52-62. [PMID: 28888393 DOI: 10.1016/j.ijpp.2017.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/02/2017] [Accepted: 05/15/2017] [Indexed: 06/07/2023]
Abstract
Hypertrophic osteoarthropathy (HOA) is a pathological condition characterised by extensive periosteal new bone formation (NBF) on the diaphyses of the long bones, metacarpal and metatarsal bones. In modern clinical contexts, the secondary form of the disease is common and most often occurs secondary to intra-thoracic cancer and other forms of chronic pulmonary disease. Paleopathological evidence for HOA on the other hand has only occasionally been reported. Here we report a young adult male from the Meriotic cemetery at Berber in Sudan (2nd-3rd century CE) displaying widespread NBF on the diaphyses of the upper and lower limb bones, metacarpal and metatarsal bones, as well as the pelvis and scapulae. While several pathological conditions have to be considered as differential diagnostic options for NBF in the post-cranial skeleton, HOA is the most likely diagnosis, based on the distribution of the changes observed in this individual, as well as their macroscopic and radiographic characteristics. A chronic pulmonary condition as indicated by NBF on the visceral side of the ribs may represent the underlying cause for the HOA. This individual represents the first paleopathological case of HOA reported from an archaeological site in Africa.
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Affiliation(s)
- M Binder
- Austrian Archaeological Institute, Austrian Academy of Sciences, Franz Klein-Gasse 1, 1190 Vienna, Austria.
| | - M Saad
- National Corporation for Antiquities and Museums of Sudan, PO Box 178, Khartoum, Sudan
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