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Masiu R, Pedersen DD, Hill L, Steyn M. The association between skeletal lesions and tuberculosis in a pre-antibiotic South African sample. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2023; 40:20-32. [PMID: 36444782 DOI: 10.1016/j.ijpp.2022.11.001] [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: 03/28/2022] [Revised: 10/13/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This study assessed the sensitivity and specificity of skeletal lesions to accurately diagnose TB in a pre-antibiotic South African skeletal sample. MATERIALS A total of 435 skeletons of individuals who died before 1950 from the Raymond A. Dart Collection of Human Skeletons. 176 died of TB, 109 died of other pulmonary diseases, and 150 died of other causes. METHODS The presence / absence of 23 skeletal lesions were assessed for differences in frequency between groups. Sensitivities and specificities were calculated and compared to Dangvard Pedersen et al. (2019). RESULTS Lesions on the ventral surface of thoracic and lumbar vertebral bodies were observed significantly more often in TB and pulmonary cases than in other cause of death group and yielded a 55% probability of a true TB diagnosis, if observed. An association between skeletal lesions and TB was found for rib and vertebral lesions. CONCLUSIONS The results suggest that even when not documented to have died of TB, TB-related changes are observed in many individuals in a South African skeletal sample, indicating that they may have been infected with the disease. SIGNIFICANCE The study provides information that can assist palaeopathologists in making inferences about the prevalence of TB in past populations. LIMITATIONS Sample sizes were small, and the inclusion of a pulmonary disease group may have confounded the results. SUGGESTIONS FOR FURTHER RESEARCH The selection of a control group without any possible contact with TB may improve the results and should be investigated.
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Affiliation(s)
- Rethabile Masiu
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Basic Medical Sciences, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
| | - Dorthe Dangvard Pedersen
- Unit of Anthropology (ADBOU), Department of Forensic Medicine, University of Southern Denmark, Odense, Denmark
| | - Lawrence Hill
- Department of Forensic Medicine & Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Maryna Steyn
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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2
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Majander K, Pfrengle S, Kocher A, Neukamm J, du Plessis L, Pla-Díaz M, Arora N, Akgül G, Salo K, Schats R, Inskip S, Oinonen M, Valk H, Malve M, Kriiska A, Onkamo P, González-Candelas F, Kühnert D, Krause J, Schuenemann VJ. Ancient Bacterial Genomes Reveal a High Diversity of Treponema pallidum Strains in Early Modern Europe. Curr Biol 2020; 30:3788-3803.e10. [PMID: 32795443 DOI: 10.1016/j.cub.2020.07.058] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/24/2020] [Accepted: 07/16/2020] [Indexed: 12/30/2022]
Abstract
Syphilis is a globally re-emerging disease, which has marked European history with a devastating epidemic at the end of the 15th century. Together with non-venereal treponemal diseases, like bejel and yaws, which are found today in subtropical and tropical regions, it currently poses a substantial health threat worldwide. The origins and spread of treponemal diseases remain unresolved, including syphilis' potential introduction into Europe from the Americas. Here, we present the first genetic data from archaeological human remains reflecting a high diversity of Treponema pallidum in early modern Europe. Our study demonstrates that a variety of strains related to both venereal syphilis and yaws-causing T. pallidum subspecies were already present in Northern Europe in the early modern period. We also discovered a previously unknown T. pallidum lineage recovered as a sister group to yaws- and bejel-causing lineages. These findings imply a more complex pattern of geographical distribution and etiology of early treponemal epidemics than previously understood.
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Affiliation(s)
- Kerttu Majander
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland; Institute for Archaeological Sciences, University of Tübingen, Rümelinstrasse 19-23, 72070 Tübingen, Germany; Department of Archaeogenetics, Max Planck Institute for the Science of Human History, Kahlaische Strasse 10, 07745 Jena, Germany; Department of Biosciences, University of Helsinki, Viikinkaari 9, 00014 Helsinki, Finland.
| | - Saskia Pfrengle
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland; Institute for Archaeological Sciences, University of Tübingen, Rümelinstrasse 19-23, 72070 Tübingen, Germany
| | - Arthur Kocher
- Transmission, Infection, Diversification and Evolution Group, Max Planck Institute for the Science of Human History, Kahlaische Strasse 10, 07745 Jena, Germany
| | - Judith Neukamm
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland; Institute for Archaeological Sciences, University of Tübingen, Rümelinstrasse 19-23, 72070 Tübingen, Germany; Institute for Bioinformatics and Medical Informatics, University of Tübingen, Sand 14, 72076 Tübingen, Germany
| | | | - Marta Pla-Díaz
- Joint Research Unit "Infection and Public Health" FISABIO-University of Valencia, Institute for Integrative Systems Biology (I2SysBio), Valencia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Natasha Arora
- Zurich Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland
| | - Gülfirde Akgül
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Kati Salo
- Department of Biosciences, University of Helsinki, Viikinkaari 9, 00014 Helsinki, Finland; Archaeology, Faculty of Arts, University of Helsinki, Unioninkatu 38F, 00014 Helsinki, Finland
| | - Rachel Schats
- Laboratory for Human Osteoarchaeology, Faculty of Archaeology, Leiden University, Einsteinweg 2, 2333CC Leiden, the Netherlands
| | - Sarah Inskip
- McDonald Institute for Archaeological Research, University of Cambridge, Downing Street, Cambridge CB2 3ER, UK
| | - Markku Oinonen
- Laboratory of Chronology, Finnish Museum of Natural History, University of Helsinki, Gustaf Hällströmin katu 2, 00560 Helsinki, Finland
| | - Heiki Valk
- Institute of History and Archaeology, University of Tartu, Jakobi 2, 51005 Tartu, Tartumaa, Estonia
| | - Martin Malve
- Institute of History and Archaeology, University of Tartu, Jakobi 2, 51005 Tartu, Tartumaa, Estonia
| | - Aivar Kriiska
- Institute of History and Archaeology, University of Tartu, Jakobi 2, 51005 Tartu, Tartumaa, Estonia
| | - Päivi Onkamo
- Department of Biosciences, University of Helsinki, Viikinkaari 9, 00014 Helsinki, Finland; Department of Biology, University of Turku, Vesilinnantie 5, 20500 Turku, Finland
| | - Fernando González-Candelas
- Joint Research Unit "Infection and Public Health" FISABIO-University of Valencia, Institute for Integrative Systems Biology (I2SysBio), Valencia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Denise Kühnert
- Transmission, Infection, Diversification and Evolution Group, Max Planck Institute for the Science of Human History, Kahlaische Strasse 10, 07745 Jena, Germany
| | - Johannes Krause
- Institute for Archaeological Sciences, University of Tübingen, Rümelinstrasse 19-23, 72070 Tübingen, Germany; Department of Archaeogenetics, Max Planck Institute for the Science of Human History, Kahlaische Strasse 10, 07745 Jena, Germany; Senckenberg Centre for Human Evolution and Palaeoenvironment (S-HEP), University of Tübingen, Tübingen, Germany.
| | - Verena J Schuenemann
- Institute of Evolutionary Medicine, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland; Institute for Archaeological Sciences, University of Tübingen, Rümelinstrasse 19-23, 72070 Tübingen, Germany; Senckenberg Centre for Human Evolution and Palaeoenvironment (S-HEP), University of Tübingen, Tübingen, Germany.
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3
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Giffin K, Lankapalli AK, Sabin S, Spyrou MA, Posth C, Kozakaitė J, Friedrich R, Miliauskienė Ž, Jankauskas R, Herbig A, Bos KI. A treponemal genome from an historic plague victim supports a recent emergence of yaws and its presence in 15 th century Europe. Sci Rep 2020; 10:9499. [PMID: 32528126 PMCID: PMC7290034 DOI: 10.1038/s41598-020-66012-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/30/2020] [Indexed: 12/30/2022] Open
Abstract
Developments in techniques for identification of pathogen DNA in archaeological samples can expand our resolution of disease detection. Our application of a non-targeted molecular screening tool for the parallel detection of pathogens in historical plague victims from post-medieval Lithuania revealed the presence of more than one active disease in one individual. In addition to Yersinia pestis, we detected and genomically characterized a septic infection of Treponema pallidum pertenue, a subtype of the treponemal disease family recognised as the cause of the tropical disease yaws. Our finding in northern Europe of a disease that is currently restricted to equatorial regions is interpreted within an historical framework of intercontinental trade and potential disease movements. Through this we offer an alternative hypothesis for the history and evolution of the treponemal diseases, and posit that yaws be considered an important contributor to the sudden epidemic of late 15th century Europe that is widely ascribed to syphilis.
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Affiliation(s)
- Karen Giffin
- Max Planck Institute for the Science of Human History, Jena, Germany
| | | | - Susanna Sabin
- Max Planck Institute for the Science of Human History, Jena, Germany
| | - Maria A Spyrou
- Max Planck Institute for the Science of Human History, Jena, Germany
| | - Cosimo Posth
- Max Planck Institute for the Science of Human History, Jena, Germany.,Institute for Archaeological Sciences, Archaeo- and Palaeogenetics, University of Tübingen, Rümelinstraße 23, 72070, Tübingen, Germany
| | | | | | | | | | - Alexander Herbig
- Max Planck Institute for the Science of Human History, Jena, Germany.
| | - Kirsten I Bos
- Max Planck Institute for the Science of Human History, Jena, Germany.
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Abstract
Researchers from the Division of Paleopathology of Pisa University (Pisa, Italy) exhumed the well-preserved skeleton of Maria Salviati (1499–1543), wife of Giovanni de’ Medici, named “Giovanni of the Black Bands,” in Florence in 2012. Many lytic lesions had affected the skull of Maria on the frontal bone and on the parietal bones. These lesions are pathognomonic for syphilis. An ancient diagnosis of syphilis for Maria Salviati does not emerge from the historical sources, although the symptoms manifested in her last years of life are compatible with a colorectal localization, including severe hemorrhages, caused by syphilitic infection. The case of Maria Salviati can be compared with those of other famous Italian noblewomen of the Renaissance, such as Isabella of Aragon (1470–1524) and Maria of Aragon (1503–1568). Paleopathology made it possible to directly observe a “secret illness” to which noblewomen were susceptible as a result of the sexual conduct of their husbands.
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5
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Mediannikov O, Fenollar F, Davoust B, Amanzougaghene N, Lepidi H, Arzouni JP, Diatta G, Sokhna C, Delerce J, Levasseur A, Raoult D. Epidemic of venereal treponematosis in wild monkeys: a paradigm for syphilis origin. New Microbes New Infect 2020; 35:100670. [PMID: 32368345 PMCID: PMC7184178 DOI: 10.1016/j.nmni.2020.100670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/19/2020] [Accepted: 03/19/2020] [Indexed: 12/01/2022] Open
Abstract
Treponema pallidum infections have been primarily known as slightly contagious mucocutaneous infections called yaws (tropical Africa and America) and bejel (subtropical North Africa). T. pallidum emerged as a highly infectious venereal syphilis agent in South America, probably about 500 years ago, and because of its venereal transmission, it quickly caused a worldwide pandemic. The disease manifests as lesions, including a chancre; then antibodies become detectable when or slightly after the chancre appears, and before the development of a rash and other systemic manifestations. Venereal diseases are poorly known in monkeys. During fieldwork in Senegal, we discovered an epizootic outbreak of venereal disease that we explored. We detected a venereal form of T. pallidum subsp. pertenue infection in green monkeys (Chlorocebus sabaeus), then observed an epizootic outbreak in Senegal and its spread among baboons a year later. Comparative analysis of T. pallidum genomes from the monkeys' chancres and other Treponema genomes showed an acceleration of the number of single nucleotide polymorphisms, comparable to that observed in syphilis. Identified T. pallidum clones seem to be epizootic through the acceleration of their mutation rate, which is linked to their larger diffusion.
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Affiliation(s)
- O. Mediannikov
- Aix Marseille Univ, IRD, AP-HM, MEФI, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - F. Fenollar
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - B. Davoust
- Aix Marseille Univ, IRD, AP-HM, MEФI, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - N. Amanzougaghene
- Aix Marseille Univ, IRD, AP-HM, MEФI, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - H. Lepidi
- Aix Marseille Univ, IRD, AP-HM, MEФI, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - J.-P. Arzouni
- Aix Marseille Univ, IRD, AP-HM, MEФI, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - G. Diatta
- VITROME, Campus International UCAD-IRD, Dakar, Senegal
| | - C. Sokhna
- IHU-Méditerranée Infection, Marseille, France
- Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - J. Delerce
- Aix Marseille Univ, IRD, AP-HM, MEФI, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - A. Levasseur
- Aix Marseille Univ, IRD, AP-HM, MEФI, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - D. Raoult
- Aix Marseille Univ, IRD, AP-HM, MEФI, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
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6
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Baker BJ, Crane-Kramer G, Dee MW, Gregoricka LA, Henneberg M, Lee C, Lukehart SA, Mabey DC, Roberts CA, Stodder ALW, Stone AC, Winingear S. Advancing the understanding of treponemal disease in the past and present. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 171 Suppl 70:5-41. [PMID: 31956996 DOI: 10.1002/ajpa.23988] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 12/11/2022]
Abstract
Syphilis was perceived to be a new disease in Europe in the late 15th century, igniting a debate about its origin that continues today in anthropological, historical, and medical circles. We move beyond this age-old debate using an interdisciplinary approach that tackles broader questions to advance the understanding of treponemal infection (syphilis, yaws, bejel, and pinta). How did the causative organism(s) and humans co-evolve? How did the related diseases caused by Treponema pallidum emerge in different parts of the world and affect people across both time and space? How are T. pallidum subspecies related to the treponeme causing pinta? The current state of scholarship in specific areas is reviewed with recommendations made to stimulate future work. Understanding treponemal biology, genetic relationships, epidemiology, and clinical manifestations is crucial for vaccine development today and for investigating the distribution of infection in both modern and past populations. Paleopathologists must improve diagnostic criteria and use a standard approach for recording skeletal lesions on archaeological human remains. Adequate contextualization of cultural and environmental conditions is necessary, including site dating and justification for any corrections made for marine or freshwater reservoir effects. Biogeochemical analyses may assess aquatic contributions to diet, physiological changes arising from treponemal disease and its treatments (e.g., mercury), or residential mobility of those affected. Shifting the focus from point of origin to investigating who is affected (e.g., by age/sex or socioeconomic status) and disease distribution (e.g., coastal/ inland, rural/urban) will advance our understanding of the treponemal disease and its impact on people through time.
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Affiliation(s)
- Brenda J Baker
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona
| | - Gillian Crane-Kramer
- Department of Anthropology, State University of New York at Plattsburgh, Plattsburgh, New York
| | - Michael W Dee
- Centre for Isotope Research, University of Groningen, Groningen, Netherlands
| | - Lesley A Gregoricka
- Department of Sociology, Anthropology, and Social Work, University of South Alabama, Mobile, Alabama
| | - Maciej Henneberg
- Biological Anthropology and Comparative Anatomy Unit, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Christine Lee
- Department of Anthropology, California State University Los Angeles, Los Angeles, California
| | - Sheila A Lukehart
- Department of Medicine/Infectious Diseases and Global Health, University of Washington, Seattle, Washington
| | - David C Mabey
- Communicable Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Ann L W Stodder
- Office of Archaeological Studies, The Museum of New Mexico, Santa Fe, New Mexico
| | - Anne C Stone
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona
| | - Stevie Winingear
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona
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7
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Sun J, Meng Z, Wu K, Liu B, Zhang S, Liu Y, Wang Y, Zheng H, Huang J, Zhou P. Tracing the origin of Treponema pallidum in China using next-generation sequencing. Oncotarget 2018; 7:42904-42918. [PMID: 27344187 PMCID: PMC5189996 DOI: 10.18632/oncotarget.10154] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 06/01/2016] [Indexed: 12/29/2022] Open
Abstract
Syphilis is a systemic sexually transmitted disease caused by Treponema pallidum ssp. pallidum (TPA). The origin and genetic background of Chinese TPA strains remain unclear. We identified a total of 329 single-nucleotide variants (SNVs) in eight Chinese TPA strains using next-generation sequencing. All of the TPA strains were clustered into three lineages, and Chinese TPA strains were grouped in Lineage 2 based on phylogenetic analysis. The phylogeographical data showed that TPA strains originated earlier than did T. pallidum ssp. pertenue (TPE) and T. pallidum ssp. endemicum (TPN) strains and that Chinese TPA strains might be derived from recombination between Lineage 1 and Lineage 3. Moreover, we found through a homology modeling analysis that a nonsynonymous substitution (I415F) in the PBP3 protein might affect the structural flexibility of PBP3 and the binding constant for substrates based on its possible association with penicillin resistance in T. pallidum. Our findings provide new insight into the molecular foundation of the evolutionary origin of TPA and support the development of novel diagnostic/therapeutic technology for syphilis.
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Affiliation(s)
- Jun Sun
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, China
| | - Zhefeng Meng
- Oncology Bioinformatics Center, Minhang Hospital, Fudan University, Shanghai, China
| | - Kaiqi Wu
- School of Laboratory Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Biao Liu
- School of Laboratory Medicine, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Sufang Zhang
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, China
| | - Yudan Liu
- Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, China
| | - Yuezhu Wang
- Shanghai-MOST Key Laboratory for Disease and Health Genomics, Chinese National Human Genome Center and National Engineering Center for Biochip at Shanghai, Shanghai, China
| | - Huajun Zheng
- Shanghai-MOST Key Laboratory for Disease and Health Genomics, Chinese National Human Genome Center and National Engineering Center for Biochip at Shanghai, Shanghai, China
| | - Jian Huang
- Shanghai-MOST Key Laboratory for Disease and Health Genomics, Chinese National Human Genome Center and National Engineering Center for Biochip at Shanghai, Shanghai, China.,Key Laboratory of Systems Biomedicine (Ministry of Education) and Collaborative Innovation Center of Systems Biomedicine, Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China
| | - Pingyu Zhou
- STD Institute, Shanghai Skin Disease Hospital, Shanghai, China.,Shanghai Skin Disease Hospital, Clinical School of Anhui Medical University, Shanghai, China
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8
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Charlier P, Galassi FM, Bouabdallah F, Deo S. A medical training skull in a portrait attributed to Annibale Carracci (ca. 1580-85). J Neurol Sci 2017; 375:402-403. [PMID: 28320177 DOI: 10.1016/j.jns.2017.02.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 01/31/2017] [Accepted: 02/21/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Philippe Charlier
- Section of Medical and Forensic Anthropology (UVSQ/EA 4569 Paris Descartes University), UFR of Health Sciences (UVSQ), Montigny-Le-Bretonneux 78180, France.
| | - Francesco M Galassi
- University of Zurich, Institute of Evolutionary Medicine, Zurich, Switzerland
| | - Fabiola Bouabdallah
- Section of Medical and Forensic Anthropology (UVSQ/EA 4569 Paris Descartes University), UFR of Health Sciences (UVSQ), Montigny-Le-Bretonneux 78180, France
| | - Saudamini Deo
- Section of Medical and Forensic Anthropology (UVSQ/EA 4569 Paris Descartes University), UFR of Health Sciences (UVSQ), Montigny-Le-Bretonneux 78180, France
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9
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LOPEZ BELÉN, LOPEZ-GARCIA JOSÉMANUEL, COSTILLA SERAFÍN, GARCIA-VAZQUEZ EVA, DOPICO EDUARDO, PARDIÑAS ANTONIOF. Treponemal disease in the Old World? Integrated palaeopathological assessment of a 9th–11th century skeleton from north-central Spain. ANTHROPOL SCI 2017. [DOI: 10.1537/ase.170515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- BELÉN LOPEZ
- Departamento de Biología de Organismos y Sistemas, Universidad de Oviedo, Oviedo
| | - JOSÉ MANUEL LOPEZ-GARCIA
- Departamento de Morfología y Biología Celular, Facultad de Medicina, Universidad de Oviedo, Oviedo
| | - SERAFÍN COSTILLA
- Hospital Universitario Central de Asturias, Servicio de Radiodiagnóstico, Oviedo
| | - EVA GARCIA-VAZQUEZ
- Departamento de Biología Funcional, Facultad de Medicina, Universidad de Oviedo, Oviedo
| | - EDUARDO DOPICO
- Departamento de Ciencias de la Educación, Facultad Formación Profesorado y Educación, Universidad de Oviedo, Oviedo
| | - ANTONIO F. PARDIÑAS
- Departamento de Biología de Organismos y Sistemas, Universidad de Oviedo, Oviedo
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10
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Abstract
The agents of human treponematoses include four closely related members of the genus Treponema: three subspecies of Treponema pallidum plus Treponema carateum. T. pallidum subsp. pallidum causes venereal syphilis, while T. pallidum subsp. pertenue, T. pallidum subsp. endemicum, and T. carateum are the agents of the endemic treponematoses yaws, bejel (or endemic syphilis), and pinta, respectively. All human treponematoses share remarkable similarities in pathogenesis and clinical manifestations, consistent with the high genetic and antigenic relatedness of their etiological agents. Distinctive features have been identified in terms of age of acquisition, most common mode of transmission, and capacity for invasion of the central nervous system and fetus, although the accuracy of these purported differences is debated among investigators and no biological basis for these differences has been identified to date. In 2012, the World Health Organization (WHO) officially set a goal for yaws eradication by 2020. This challenging but potentially feasible endeavor is favored by the adoption of oral azithromycin for mass treatment and the currently focused distribution of yaws and endemic treponematoses and has revived global interest in these fascinating diseases and their causative agents.
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Affiliation(s)
- Lorenzo Giacani
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Sheila A. Lukehart
- Department of Medicine, University of Washington, Seattle, Washington, USA
- Department of Global Health, University of Washington, Seattle, Washington, USA
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11
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Smajs D, Norris SJ, Weinstock GM. Genetic diversity in Treponema pallidum: implications for pathogenesis, evolution and molecular diagnostics of syphilis and yaws. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2012; 12:191-202. [PMID: 22198325 PMCID: PMC3786143 DOI: 10.1016/j.meegid.2011.12.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Revised: 12/05/2011] [Accepted: 12/07/2011] [Indexed: 02/08/2023]
Abstract
Pathogenic uncultivable treponemes, similar to syphilis-causing Treponema pallidum subspecies pallidum, include T. pallidum ssp. pertenue, T. pallidum ssp. endemicum and Treponema carateum, which cause yaws, bejel and pinta, respectively. Genetic analyses of these pathogens revealed striking similarity among these bacteria and also a high degree of similarity to the rabbit pathogen, Treponema paraluiscuniculi, a treponeme not infectious to humans. Genome comparisons between pallidum and non-pallidum treponemes revealed genes with potential involvement in human infectivity, whereas comparisons between pallidum and pertenue treponemes identified genes possibly involved in the high invasivity of syphilis treponemes. Genetic variability within syphilis strains is considered as the basis of syphilis molecular epidemiology with potential to detect more virulent strains, whereas genetic variability within a single strain is related to its ability to elude the immune system of the host. Genome analyses also shed light on treponemal evolution and on chromosomal targets for molecular diagnostics of treponemal infections.
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Affiliation(s)
- David Smajs
- Department of Biology, Faculty of Medicine, Masaryk University, Kamenice 5, Building A6, 625 00 Brno, Czech Republic.
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Harper KN, Zuckerman MK, Harper ML, Kingston JD, Armelagos GJ. The origin and antiquity of syphilis revisited: An Appraisal of Old World pre-Columbian evidence for treponemal infection. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2011; 146 Suppl 53:99-133. [DOI: 10.1002/ajpa.21613] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Cole G, Waldron T. Apple Down 152: A putative case of syphilis from sixth century AD Anglo-Saxon England. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2010; 144:72-9. [DOI: 10.1002/ajpa.21371] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 05/28/2010] [Indexed: 11/06/2022]
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Abstract
OBJECTIVES Syphilis has changed the course of history, shaped the path of medicine and had more influence on psychiatry than any other illness. This paper, part one of a two-part series, investigates the historical, social and cultural aspects of the interaction of syphilis and psychiatry. CONCLUSION Syphilis did not manifest as a psychiatric illness until the French Revolution. At the time, the Pinel School was focussing on the environment and moral therapy. Bayle, who made the first discovery of the cause of a psychiatric disease - chronic arachnoiditis - paid the price for his discovery by being driven from psychiatry. The 19th century led to the rise of a new medical polymath: the syphilologist - a specialist in every aspect of a disease that showed a remarkable capacity to affect every organ and tissue in the body and produce symptoms resembling other illnesses. The field was dominated by Frenchmen, Philippe Ricord and Alfred Fournier, and Englishman Jonathan Hutchinson. A middle-class illness, neurosyphilis struck at the heart of the class interests - property. This reeked havoc with the family business or finances, causing considerable distress to their relatives. General paresis of the insane became associated in the public eye with creative, intellectual or philosophical activity. It affected a long list of artists, writers and musicians, including Oscar Wilde, Robert Schumann, Baudelaire, Schubert and Ivan the Terrible. While the features of syphilis were delineated, confirmation remained elusive and neurosyphilis continued to hide its secrets. It remained the grand cause that defined psychiatry and it was not until the middle of the 20th century that it ceased to play a part in the daily life of doctors in psychiatric wards.
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de Melo FL, de Mello JCM, Fraga AM, Nunes K, Eggers S. Syphilis at the crossroad of phylogenetics and paleopathology. PLoS Negl Trop Dis 2010; 4:e575. [PMID: 20052268 PMCID: PMC2793018 DOI: 10.1371/journal.pntd.0000575] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2009] [Accepted: 11/16/2009] [Indexed: 11/17/2022] Open
Abstract
The origin of syphilis is still controversial. Different research avenues explore its fascinating history. Here we employed a new integrative approach, where paleopathology and molecular analyses are combined. As an exercise to test the validity of this approach we examined different hypotheses on the origin of syphilis and other human diseases caused by treponemes (treponematoses). Initially, we constructed a worldwide map containing all accessible reports on palaeopathological evidences of treponematoses before Columbus's return to Europe. Then, we selected the oldest ones to calibrate the time of the most recent common ancestor of Treponema pallidum subsp. pallidum, T. pallidum subsp. endemicum and T. pallidum subsp. pertenue in phylogenetic analyses with 21 genetic regions of different T. pallidum strains previously reported. Finally, we estimated the treponemes' evolutionary rate to test three scenarios: A) if treponematoses accompanied human evolution since Homo erectus; B) if venereal syphilis arose very recently from less virulent strains caught in the New World about 500 years ago, and C) if it emerged in the Americas between 16,500 and 5,000 years ago. Two of the resulting evolutionary rates were unlikely and do not explain the existent osseous evidence. Thus, treponematoses, as we know them today, did not emerge with H. erectus, nor did venereal syphilis appear only five centuries ago. However, considering 16,500 years before present (yBP) as the time of the first colonization of the Americas, and approximately 5,000 yBP as the oldest probable evidence of venereal syphilis in the world, we could not entirely reject hypothesis C. We confirm that syphilis seems to have emerged in this time span, since the resulting evolutionary rate is compatible with those observed in other bacteria. In contrast, if the claims of precolumbian venereal syphilis outside the Americas are taken into account, the place of origin remains unsolved. Finally, the endeavor of joining paleopathology and phylogenetics proved to be a fruitful and promising approach for the study of infectious diseases. Syphilis is a reemerging disease burden. Although it has been studied for five centuries, its origin and spread is still controversial. Did it accompany the evolution of the genus Homo and does it date back to more than a million years or did it emerge only after Columbus's return to Europe? Initially, to test the validity of a new interdisciplinary approach we constructed a worldwide map showing precolumbian human skeletons with lesions of syphilis and other related diseases (also caused by different treponemes). Then, we selected the oldest cases to estimate the timing of the treponemes' history, using their DNA sequences and computer simulations. This resulted in treponeme evolutionary rates, and in temporal intervals during which these microorganisms could have emerged. Based on comparisons with other bacteria, we concluded that treponematoses did not emerge before our own species originated and that syphilis did not start affecting mankind only from 1492 onwards. Instead, it seems to have emerged in the time span between 16,500 and 5,000 years ago. Where syphilis emerged, however, remains unsolved. Finally, the endeavor of joining as distinct fields as paleopathology and molecular biology proved to be fruitful and promising to advance our understanding of the rise and fall of the infectious diseases that have afflicted humans across time and space.
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Affiliation(s)
- Fernando Lucas de Melo
- Departamento de Microbiologia, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, Brazil
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Syphilis makes another comeback. Am J Nurs 2008; 108:28, 30-1. [PMID: 18227665 DOI: 10.1097/01.naj.0000310327.70680.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Harper KN, Ocampo PS, Steiner BM, George RW, Silverman MS, Bolotin S, Pillay A, Saunders NJ, Armelagos GJ. On the origin of the treponematoses: a phylogenetic approach. PLoS Negl Trop Dis 2008; 2:e148. [PMID: 18235852 PMCID: PMC2217670 DOI: 10.1371/journal.pntd.0000148] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Accepted: 11/15/2007] [Indexed: 11/18/2022] Open
Abstract
Background Since the first recorded epidemic of syphilis in 1495, controversy has surrounded the origins of the bacterium Treponema pallidum subsp. pallidum and its relationship to the pathogens responsible for the other treponemal diseases: yaws, endemic syphilis, and pinta. Some researchers have argued that the syphilis-causing bacterium, or its progenitor, was brought from the New World to Europe by Christopher Columbus and his men, while others maintain that the treponematoses, including syphilis, have a much longer history on the European continent. Methodology/Principal Findings We applied phylogenetics to this problem, using data from 21 genetic regions examined in 26 geographically disparate strains of pathogenic Treponema. Of all the strains examined, the venereal syphilis-causing strains originated most recently and were more closely related to yaws-causing strains from South America than to other non-venereal strains. Old World yaws-causing strains occupied a basal position on the tree, indicating that they arose first in human history, and a simian strain of T. pallidum was found to be indistinguishable from them. Conclusions/Significance Our results lend support to the Columbian theory of syphilis's origin while suggesting that the non-sexually transmitted subspecies arose earlier in the Old World. This study represents the first attempt to address the problem of the origin of syphilis using molecular genetics, as well as the first source of information regarding the genetic make-up of non-venereal strains from the Western hemisphere. For 500 years, controversy has raged around the origin of T. pallidum subsp. pallidum, the bacterium responsible for syphilis. Did Christopher Columbus and his men introduce this pathogen into Renaissance Europe, after contracting it during their voyage to the New World? Or does syphilis have a much older history in the Old World? This paper represents the first attempt to use a phylogenetic approach to solve this question. In addition, it clarifies the evolutionary relationships between the pathogen that causes syphilis and the other T. pallidum subspecies, which cause the neglected tropical diseases yaws and endemic syphilis. Using a collection of pathogenic Treponema strains that is unprecedented in size, we show that yaws appears to be an ancient infection in humans while venereal syphilis arose relatively recently in human history. In addition, the closest relatives of syphilis-causing strains identified in this study were found in South America, providing support for the Columbian theory of syphilis's origin.
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Affiliation(s)
- Kristin N. Harper
- Department of Population Biology, Ecology, and Evolution, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Paolo S. Ocampo
- School of Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Bret M. Steiner
- Laboratory Reference and Research Branch, Division of Sexually Transmitted Diseases Prevention, NCHHSTP, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Robert W. George
- Laboratory Reference and Research Branch, Division of Sexually Transmitted Diseases Prevention, NCHHSTP, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Michael S. Silverman
- Department of Medicine, Division of Infectious Diseases, University of Toronto, Ontario, Canada
- Lakeridge Health Centre, Ontario, Canada
| | - Shelly Bolotin
- Department of Microbiology, Mount Sinai Hospital, Toronto, Canada
| | - Allan Pillay
- Laboratory Reference and Research Branch, Division of Sexually Transmitted Diseases Prevention, NCHHSTP, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Nigel J. Saunders
- Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom
| | - George J. Armelagos
- Department of Anthropology, Emory University, Atlanta, Georgia, United States of America
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Affiliation(s)
- Laura A Teasley
- Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Boston, MA 02114, USA
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Richens J. Sexually transmitted infections and HIV among travellers: A review. Travel Med Infect Dis 2006; 4:184-95. [PMID: 16887740 DOI: 10.1016/j.tmaid.2005.06.010] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2005] [Accepted: 06/21/2005] [Indexed: 11/20/2022]
Abstract
Sexually transmitted infections are often acquired during travel. Infections are most often seen in young adults, travelling without a regular partner and among those who have higher numbers of partners while at home. Alcohol and recreational drug use may increase risk. The risks are highest from having unprotected sex with local partners in developing countries where the prevalence of infection can be many times higher than at home. The risks of acquiring HIV are highest in Africa, followed by South Asia. Special precautions are required by those going to work in health-care settings in high HIV prevalence countries. Travellers may benefit from advice about safer sex, condom use, emergency contraception and vaccination against hepatitis B. In special circumstances a starter pack for HIV post-exposure prophylaxis should be considered. Following return travellers should consider attending specialist services for a screen for sexually transmitted infections and HIV if they are concerned about exposure whilst travelling. A number of reports suggest that travel clinics need to pay more attention to the sexual health of travellers.
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Affiliation(s)
- John Richens
- Department of Genito-Urinary Medicine, Mortimer Market Centre, Camden Primary Care Trust NHS, London, UK.
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Knell RJ. Syphilis in renaissance Europe: rapid evolution of an introduced sexually transmitted disease? Proc Biol Sci 2004; 271 Suppl 4:S174-6. [PMID: 15252975 PMCID: PMC1810019 DOI: 10.1098/rsbl.2003.0131] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
When syphilis first appeared in Europe in 1495, it was an acute and extremely unpleasant disease. After only a few years it was less severe than it once was, and it changed over the next 50 years into a milder, chronic disease. The severe early symptoms may have been the result of the disease being introduced into a new host population without any resistance mechanisms, but the change in virulence is most likely to have happened because of selection favouring milder strains of the pathogen. The symptoms of the virulent early disease were both debilitating and obvious to potential sexual partners of the infected, and strains that caused less obvious or painful symptoms would have enjoyed a higher transmission rate.
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Affiliation(s)
- Robert J Knell
- School of Biological Sciences, Queen Mary, University of London, Mile End Road, London E1 4NS, UK.
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