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Majander K, Pla-Díaz M, du Plessis L, Arora N, Filippini J, Pezo-Lanfranco L, Eggers S, González-Candelas F, Schuenemann VJ. Redefining the treponemal history through pre-Columbian genomes from Brazil. Nature 2024; 627:182-188. [PMID: 38267579 PMCID: PMC10917687 DOI: 10.1038/s41586-023-06965-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/12/2023] [Indexed: 01/26/2024]
Abstract
The origins of treponemal diseases have long remained unknown, especially considering the sudden onset of the first syphilis epidemic in the late 15th century in Europe and its hypothesized arrival from the Americas with Columbus' expeditions1,2. Recently, ancient DNA evidence has revealed various treponemal infections circulating in early modern Europe and colonial-era Mexico3-6. However, there has been to our knowledge no genomic evidence of treponematosis recovered from either the Americas or the Old World that can be reliably dated to the time before the first trans-Atlantic contacts. Here, we present treponemal genomes from nearly 2,000-year-old human remains from Brazil. We reconstruct four ancient genomes of a prehistoric treponemal pathogen, most closely related to the bejel-causing agent Treponema pallidum endemicum. Contradicting the modern day geographical niche of bejel in the arid regions of the world, the results call into question the previous palaeopathological characterization of treponeme subspecies and showcase their adaptive potential. A high-coverage genome is used to improve molecular clock date estimations, placing the divergence of modern T. pallidum subspecies firmly in pre-Columbian times. Overall, our study demonstrates the opportunities within archaeogenetics to uncover key events in pathogen evolution and emergence, paving the way to new hypotheses on the origin and spread of treponematoses.
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Affiliation(s)
- Kerttu Majander
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.
- Department of Evolutionary Anthropology, University of Vienna, Vienna, Austria.
- Department of Environmental Sciences, University of Basel, Basel, Switzerland.
| | - Marta Pla-Díaz
- Unidad Mixta Infección y Salud Pública, FISABIO/Universidad de Valencia-I2SysBio, Valencia, Spain
- CIBER in Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Louis du Plessis
- Department of Biosystems Science and Engineering, ETH Zürich, Basel, Switzerland
- Swiss Institute of Bioinformatics, Quartier Sorge, Lausanne, Switzerland
| | - Natasha Arora
- Zurich Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Jose Filippini
- Department of Genetic and Evolutionary Biology, University of São Paulo, São Paulo, Brazil
| | - Luis Pezo-Lanfranco
- Department of Genetic and Evolutionary Biology, University of São Paulo, São Paulo, Brazil
- Institute of Environmental Science and Technology (ICTA) and Prehistory Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Sabine Eggers
- Department of Genetic and Evolutionary Biology, University of São Paulo, São Paulo, Brazil
- Department of Anthropology, Natural History Museum Vienna, Vienna, Austria
| | - Fernando González-Candelas
- Unidad Mixta Infección y Salud Pública, FISABIO/Universidad de Valencia-I2SysBio, Valencia, Spain.
- CIBER in Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain.
| | - Verena J Schuenemann
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.
- Department of Evolutionary Anthropology, University of Vienna, Vienna, Austria.
- Department of Environmental Sciences, University of Basel, Basel, Switzerland.
- Human Evolution and Archaeological Sciences (HEAS), University of Vienna, Vienna, Austria.
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Donovanosis, Chancroid, and Endemic Treponematoses: Clinical Features and Control. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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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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Abstract
Improved understanding of the differential diagnosis of endemic treponematoses is needed to inform clinical practice and to ensure the best outcome for a new global initiative for the eradication of yaws, bejel, and pinta. Traditionally, the human treponematoses have been differentiated based upon their clinical manifestations and epidemiologic characteristics because the etiologic agents are indistinguishable in the laboratory. Serological tests are still considered standard laboratory methods for the diagnosis of endemic treponematoses and new rapid point-of-care treponemal tests have become available which are extremely useful in low-resource settings. In the past ten years, there has been an increasing effort to apply polymerase chain reaction to treponematoses and whole genome fingerprinting techniques have identified genetic signatures that can differentiate the existing treponemal strains; however, definitive diagnosis is also hampered by widespread unavailability of molecular diagnostics. We review the dilemmas in the diagnosis of endemic treponematoses, and advances in the discovery of new diagnostic tools.
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Affiliation(s)
- Oriol Mitjà
- Barcelona Centre for International Health Research, Hospital Clínic, University of Barcelona, Barcelona, Spain
- Lihir Medical Centre-InternationalSOS, Lihir Island, Papua New Guinea
| | - David Šmajs
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Quique Bassat
- Lihir Medical Centre-InternationalSOS, Lihir Island, Papua New Guinea
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Smith MO, Betsinger TK, Williams LL. Differential visibility of treponemal disease in pre-Columbian stratified societies: does rank matter? AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2010; 144:185-95. [PMID: 20740660 DOI: 10.1002/ajpa.21381] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 06/22/2010] [Indexed: 11/07/2022]
Abstract
Treponemal disease is known to be associated with the compromised community health of permanent village settlement. This association explains its high visibility in the village-based, arguably chiefdom level, agriculturalist societies of late prehistoric (AD 1300-1600) North America. Within chiefdom-level societies, health differences have often been demonstrated between mortuary-defined "elite" and "nonelite" individuals. This theoretically should predict status-based differences in treponemal disease visibility. The prediction is tested in a five-site osteological sample (N = 650) from the Dallas phase (AD 1300-1550), a simple mortuary-defined two-tiered presumptive chiefdom level maize agriculturalist socioeconomic context from lower east Tennessee. The Dallas phase results affirm a general pre-Colombian North American pattern of no sex differences and display comparable adult to subadult frequencies. The study also reveals that given a sufficient sample size, "elites" do indeed exhibit a significantly lower frequency of tertiary stage treponemal disease. This can be attributed to better baseline health, which has been previously demonstrated in this sample. It may also be affected by the mortuary inclusion of achieved status individuals whose good health may have facilitated sociopolitical advancement. Another pattern that emerged is an apparent young adult age bias in disease visibility. This suggests that tertiary treponemal disease morbidity may either directly or synergistically factor in early adult age at death. Future research will address the veracity of this association.
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Affiliation(s)
- Maria Ostendorf Smith
- Department of Sociology and Anthropology, Illinois State University, Normal, IL 61790-4660, USA.
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Abstract
Despite major efforts to eradicate these disorders, yaws, bejel, and pinta (endemic treponematosis) remain serious health issues in many regions of the world. Aside from prominent skin manifestations, these diseases may also lead to significant osseous, neurologic, and ophthalmologic complications. Although progress has been made in differentiating the causative species in a research setting, a simple, specific, and sensitive diagnostic test remains elusive. Parenteral penicillin, in appropriate dosage, is the treatment of choice; alternative antibiotics such as tetracycline and erythromycin may also be effective.
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Affiliation(s)
- Neil Farnsworth
- Department of Dermatology, Baylor College of Medicine, Houston, TX 77030, USA
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Abstract
The nonvenereal treponematoses--yaws, endemic syphilis, and pinta--constitute a major health concern for many third world countries. These diseases are caused by an organism that is morphologically and antigenically identical to the causative agent of venereal syphilis, Treponema pallidum. Nonvenereal treponematoses differ significantly in their modes of transmission, epidemiology, and clinical presentation from venereal syphilis. Like venereal syphilis, they have a chronic relapsing course and have prominent cutaneous manifestations. Recently, several cases of imported yaws and endemic syphilis have been described in Europe. With the escalating U.S. military presence in many remote areas of the world and ever-increasing world-wide travel, the diagnosis of the nonvenereal treponematoses must be considered in appropriate clinical and historical situations.
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Affiliation(s)
- A B Koff
- Department of Dermatology, Baylor College of Medicine, Houston, TX 77030
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