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PubMed1994

Frequency and chronological distribution of dental enamel hypoplasia in enslaved African Americans: a test of the weaning hypothesis.

The dentition of 27 enslaved African Americans from archaeological sites in Maryland and Virginia were examined. All 17 males and 7 of the 10 females in this study exhibited enamel hypoplastic defects indicative of systemic nutritional and disease stresses interfering with amelogenesis. Estimates of the ages of occurrence of these defects show that most occur between 1.5 and 4.5 years of age, 0.5-3.75 years later than historically documented weaning age (9-12 months of age) in similar plantation populations. Comparisons are made with studies of dental enamel hypoplasia in contemporaneous enslaved and free African American populations, including our data on 75 individuals from the First African Baptist Church cemetery in Philadelphia. These populations were highly stressed. While there appears to be a modest effect of early weaning stress, no direct relationship of peak frequencies to weaning age can be shown. These data raise questions about the attribution of peak hypoplasia frequencies to age at weaning or "post-weaning" stresses in previous paleopathological studies. High hypoplasia frequencies during the middle years of enamel development are more likely the result of a combination of 1) multiple environmental stresses, 2) differences in hypoplastic susceptibility in enamel, and 3) random factors.

Black or African American↗
PubMed2005

Trophic level and macronutrient shift effects associated with the weaning process in the Postclassic Maya.

The weaning process was investigated at two Maya sites dominated by Postclassic remains: Marco Gonzalez (100 BC-AD 1350) and San Pedro (1400-AD 1650), Belize. Bone collagen and bioapatite were analyzed from 67 individuals (n < or = 6 years = 15, n > 6 years = 52). Five isotopic measures were used to reconstruct diet and weaning: stable nitrogen- and carbon-isotope ratios in collagen, stable carbon- and oxygen-isotope ratios in bioapatite, and the difference in stable carbon-isotope values of coexisting collagen and bioapatite. Nitrogen-isotope ratios in infant collagen from both sites are distinct from adult females, indicating a trophic level effect. Collagen-to-bioapatite differences in infant bone from both sites are distinct from adult females, indicating a shift in macronutrients. Oxygen-isotope ratios in infant bioapatite from both sites are also distinct from adult females, indicating the consumption of breast milk. Among infants, carbon- and nitrogen-isotope ratios vary, indicating death during different stages in the weaning process. The ethnohistoric and paleopathological literature on the Maya indicate cessation of breast-feeding between ages 3-4 years. Isotopic data from Marco Gonzalez and San Pedro also indicate an average weaning age of 3-4 years. Based on various isotopic indicators, weaning likely began around age 12 months. This data set is not only important for understanding the weaning process during the Postclassic, but also demonstrates the use of collagen-to-bioapatite spacing as an indicator of macronutrient shifts associated with weaning.

Adolescent↗
PubMed2006

Biomechanical approach to the reconstruction of activity patterns in Neolithic Western Liguria, Italy.

This paper investigates the changes in upper and lower limb robusticity and activity patterns that accompanied the transition to a Neolithic subsistence in western Liguria (Italy). Diaphyseal robusticity measures were obtained from cross-sectional geometric properties of the humerus and femur in a sample of 16 individuals (eight males and eight females) dated to about 6,000-5,500 BP. Comparisons with European Late Upper Paleolithics (LUP) indicate increased humeral robusticity in Neolithic Ligurian (NEOL) males, but not in females, with a significant reduction in right-left differences in both sexes. Sexual dimorphism in robusticity increases in upper and lower limb bones. Regarding the femur, while all female indicators of bending strength decrease steadily through time, values for NEOL males approach those of LUP. This suggests high, and unexpected, levels of mechanical stress for NEOL males, probably reflecting the effects of the mountainous terrain on lower limb remodeling. Comparisons between NEOL males and a small sample of LUP hunter-gatherers from the same area support this interpretation. In conclusion, cross-sectional geometry data indicate that the transition to Neolithic economies in western Liguria did not reduce functional requirements in males, and suggest a marked sexual division of labor involving a more symmetrical use of the upper limb, and different male-female levels of locomotory stress. When articulated with archaeological, faunal, paleopathological, and ethnographic evidence, these results support the hypothesis of repetitive, bimanual use of axes tied to pastoral activities in males, and of more sedentary tasks linked to agriculture in females.

Adult↗
PubMedDate not supplied

Evidence of rheumatoid arthritis in ancient India.

The scarcity of references in ancient medical literature to any disease resembling rheumatoid arthritis (RA) has led many Western rheumatologists to believe that rheumatoid arthritis is a disease of relatively recent origin. In a recent paper on this problem, Short traces the first adequate description of what was probably rheumatoid arthritis to Thomas Sydenham (1624-1689) and emphasizes that European and Greek medical literature before Sydenham's time may have confused gout and other forms of polyarthritis as manifestations of the same disease (1). Studies in human paleopathology have as yet produced no convincing evidence for the existenct of RA in ancient human remains, but Short suggested that a study of the ancient medical literature of the Eastern civilizations may provide some new information on the true antiquity of rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1987

The contribution of William Hunter (1718-1783) to the study of bone and joint disease.

William Hunter (1718-1783), the elder of the two famous Hunter brothers, is best known for his remarkable book The Anatomy to the Human Gravid Uterus, and for his contributions to the art of midwifery. However, Hunter also made significant observations in cardiovascular disease, in comparative anatomy, and paleopathology. It is perhaps not sufficiently known that he also made significant contributions in rheumatic disease, and in particular, the anatomy and physiology of cartilage.

Bone Diseases↗
PubMedDate not supplied

A subject with abnormally short stature from Imperial Rome.

In spite of the rich iconographic and literary documentation from ancient sources, the skeletal evidence concerning individuals of abnormally short stature in the Greco-Roman world is scarce. The necropolis of Viale della Serenissima/Via Basiliano in Rome, mostly referable to the II century AD, recently yielded the skeleton of an individual characterized by proportionate short stature, gracile features suggesting female gender, and delayed epiphysial closure, associated with full maturation of the permanent dentition. These characteristics could be compatible with the phenotype associated with female gonadal dysgenesis. The skeletal individual described here, although poorly preserved, represents the first evidence of a paleopathologic condition affecting skeletal growth documented for the population of ancient Rome.

Adult↗
PubMed2004

[Macroscopic and endoscopic examinations of the head and neck region in ancient Egyptian mummies].

INTRODUCTION: The examination of mummies has mostly been performed by macroscopic investigation after unwrapping. During the last decades, however, several research groups provided clear evidence that the combination of various noninvasive approaches for the examination of mummies offers distinct advantages over the previously used methods of unwrapping and inspection. Particularly, the introduction of endoscopic techniques has been used for a closer examination of mummies without destroying them. METHODS: In the last 5 years we analysed about 250 mummies and skeletons found in the necropolis of Thebes-West, Upper Egypt, with particular reference to normal and pathological findings in the head and neck region. Beside macroscopic examination we used endoscopes for the inspection of the nasal cavity and the ear. RESULTS: Most individuals revealed normal macroscopic and endoscopic features. In particular, several skulls showed the auditory ossicles in normal anatomic position indicating an excellent conservation of the specimens. Nevertheless, pathological alterations could be detected affecting different regions of the head and neck. In particular, several individuals presented with fractures of the nasal bones. One case even revealed a severe old-healed fracture of the mid-face (type Le Fort III) with complete loss of all teeth, suggesting adequate "therapeutic" treatment of the skull fracture. Further findings, evidenced by endoscopy, were dentogenic sinusitis and chronic middle ear infections with intracranial perforation in one case. In addition, in one case fixation of the stapes suggests the residues of subluxation of the stapes. CONCLUSION: In this study, we provide further evidence that a careful macroscopic and endoscopic investigation of mummy skulls reveals important information on the state of conservation of the study population and may unravel distinct paleopathological diseases of the head and neck region.

Archaeology↗
PubMed2002

Ankylosing spondylitis in the pharaohs of ancient Egypt.

BACKGROUND: Among the pharaohs of the 18th and 19th dynasty of Old Egypt, at least three had ankylosing spondylitis: Amenhotep (Amenophis) II, Ramses II ("The Great"), and his son Merenptah. OBJECTIVE: An illustrated review is given on the radiological indications for their disease, together with the rough history of these pharaohs, the history of their tombs, of the detection of their mummies in the 19th century and of their paleopathological investigation.

Egypt, Ancient↗
PubMed2026

Ten millennia of purifying selection on HLA-B27 reveals an ancient epidemic-scale burden of spondyloarthritis in West Eurasia.

HLA-B27 exemplifies an evolutionary trade-off between protection against infection and susceptibility to inflammatory disease. To investigate its long-term population history, this study examined three HLA-B27-tagging variants-rs116488202, rs4349859, and rs116666910-in present-day populations from UK biobank and 1000 Genomes Project, and in 15,836 ancient West Eurasian individuals. The estimated frequency of HLA-B27 reached 49.0% approximately 8500&#xa0;years before present, then declined progressively to 3.9% in the present-day reference population. Comparison with genome-wide association study (GWAS) data for ankylosing spondylitis (AS) showed that HLA-B27-linked alleles conferring increased disease risk had negative selection coefficients, indicating sustained selection against HLA-B27 over the past 10,000&#xa0;years. The decline coincided with major Holocene changes in settlement and subsistence patterns, microbial exposure, and enteric infection, which may have increased the inflammatory costs of HLA-B27. Because previous paleopathological studies have largely been limited to identifying advanced skeletal manifestations of AS, this ancient genetic study may provide currently the most sensitive population-level record of an otherwise largely undetectable, epidemic-scale disease burden in antiquity. These findings support the hypothesis that HLA-B27-associated spondyloarthritis was sufficiently prevalent and severe to influence human evolution in prehistoric West Eurasia.

Humans↗
PubMed2005

Could single-nucleotide polymorphisms (SNPs) affecting the tumour necrosis factor promoter be considered as part of rheumatoid arthritis evolution?

Tumour necrosis factor (TNF), a cytokine mainly produced by macrophages, is associated with a broad spectrum of biological effects, mainly associated with the host defense against microbes. The TNF gene is located on chromosome six within the major histocompatibility complex (MHC). Rheumatoid arthritis (RA) is a systemic autoimmune disease where TNF plays a central role in its etiology and pathogenesis. Written medical evidence of RA can be traced at least as far back as the 17th century, while human paleopathological studies appear to show the presence of RA prior to this period. The fact that RA has experienced an increment both in severity and mortality could be explained by many causes, particularly the crucial role of the immune system. Single-nucleotide polymorphisms (SNPs) are the most common genetic variations and occur at a frequency of approximately 1 in 1000 bp throughout the genome. The -308 TNF SNP is a mutation that affects the promoter region of the TNF gene. It defines the TNF1 and TNF2 alleles, determining low and high levels of TNF expression, respectively. The presence of the TNF2 allele has also been linked to increased susceptibility to and severity in a variety of autoimmune and inflammatory disorders, including RA, systemic lupus erythematosus, and ankylosing spondylitis. Studies on the functional significance of -308 SNP have detected higher levels of TNF production by cells from TNF2-carrying individuals than cells from TNF1 individuals. This difference does not appear to be due to other genes lying within the MHC region. Since the presence of the TNF2 allele may increase the host's resistance to local infection, by increasing local production of TNF at the infection site, we may suggest that such a mutation has emerged as a selective advantage to carriers of the TNF2 allele. This hypothesis may prove itself by observing the high incidence of tuberculosis and other infectious processes in those patients treated with anti-TNF therapy. Since the human lifespan has increased, the persistence of the TNF2 allele at high frequency in the population now confers what appears to be a marked survival disadvantage. As a result of the disregulation of the immune system, the genetically-predisposed host expresses larger amounts of TNF, leading to chronic inflammatory processes and autoimmune diseases, currently more prevalent. We suggest that RA, a relatively new and increasingly frequent disease, is favored by the presence of the -308 TNF promoter polymorphism, responsible for increased TNF production.

Animals↗
PubMed1997

Epidemiological and clinical aspects relating to the variability of rheumatoid arthritis.

OBJECTIVE: To review epidemiological studies dealing with the temporal and geographic variability in the occurrence of rheumatoid arthritis (RA) and clinical studies that address the variability of severity and manifestations among populations. METHODS: An extensive search of the literature, including a Medline search, was completed. Studies addressing the origin, history, and trends in the occurrence of RA were reviewed first. Next, studies of the prevalence and incidence of RA in different populations were reviewed, and occurrence rates compared. Standardization was attempted by tabulating adult prevalence rates of studies using equivalent sets of criteria. Studies comparing RA patients from two populations were sought next. Finally, studies dealing with explanations of the presumed variability were reviewed. RESULTS: Temporal variability is indicated by paleopathological evidence that RA has existed in the New World since 4000 BC, whereas there is no evidence that it occurred in Europe before the 17th century, or in Africa before the 20th century. Epidemiological studies show a possible trend of decreasing incidence of RA in the United States and Western Europe, whereas reports from Africa note a rising incidence. In white populations of Europe and America, prevalence is approximately 1%, and incidence is 0.03%. Significantly higher rates are found in some North American Indians, and significantly lower rates in some Asian and African populations, even when the different population structures are taken into account. In the latter populations, different patterns of occurrence from those observed in whites emerge, such as greater female preponderance and a much younger peak age at onset. Direct standardized comparisons of two diverse populations of RA patients showed some differences in expression, severity, or manifestations of RA between populations. CONCLUSION: The occurrence and manifestations of RA are temporally and geographically variable.

Africa↗
PubMed1997

Immunohistochemical localisation of neuropeptides and nitric oxide synthase in sural nerves from Egyptian mummies.

Paleopathology is a well established science with numerous papers and books on the subject but, in contrast, paleoneurobiology is almost non-existent. We examined sections of sural nerves obtained from seven embalmed Egyptian mummies and one naturally desiccated Peruvian mummy, immunohistochemically stained for several neurochemicals. Immunoreactivity for type I nitric oxide synthase (NOS), protein gene-product 9.5, galanin, and calcitonin gene-related peptide immunoreactivity was observed in the nervi nervorum. No immunoreactivity was seen using antibodies directed against substance P, vasoactive intestinal polypeptide or neuropeptide Y. NOS-immunoreactivity was also observed in biopsied samples of contemporaneous human sural nerves. Thus, using a standard immunohistochemical technique it was possible to detect neurochemicals in ancient sural nerves that had been preserved by mummification. Furthermore, the finding of NOS in the ancient nerves led to its detection in contemporaneous sural nerves.

Egypt↗
PubMed2004

Paleodermatoses: lessons learned from mummies.

Mummies, the preserved remains of living beings from former times, bear witness across millennia to the maladies plaguing humankind. Disease, older than humanity, is better understood when examined in the context of history. Paleopathology, literally meaning "ancient suffering", is the study of disease through evaluation of ancient remains. This area of increasing medical interest offers insights into the management of public health issues and disease epidemiology. This article provides an introduction and overview to paleodermatology, the branch of dermatology concerned with the evaluation of diseases associated with the integument by examination of ancient human remains. Mummy sources, how they were made and used throughout history, and the multidisciplinary approach used to study skin diseases found in mummies is briefly described. Despite pervasive pseudopathology, a remarkable array of diseases are well substantiated in the paleorecord, including infectious, heritable, nutritional, hormonal, acquired, iatrogenic, and neoplastic disorders. Legitimate ethical concerns have been raised in the use of human remains for any purpose, with the lack of informed consent eliciting accusations of exploitation. While these studies are undertaken with certain risks, such as the acquisition of potentially dangerous or extinct infections, paleodermatology offers a unique and historical perspective on the afflictions of the skin and the way of all flesh.

History, Ancient↗
PubMed1978

Diffuse enthesopathic hyperostosis--anatomical and radiological study on a macerated skeleton.

Anatomico-radiological study of a macerated skeleton in a 43-year-old diabetic woman. An important spondylosis with hyperostosis of the cervical, thoracic and lumbar vertebrae was seen. There were associated changes of insertional hyperostosis at various levels, particularly at the iliac crests. Paget's disease of the left iliac crest was also noted in the corresponding hyperostosis. This case presentation offers an opportunity to discuss local mechanical factors (observed at the tendinous insertions) as well as generalized considerations on the "terrain" of diabetes and perhaps malnutrition. It also demonstrates the interest that an anatomico-radiological comparison on macerated specimens can have for certain osteoarticular research, teaching and paleopathology.

Adult↗
PubMed2002

Evidence for interpersonal violence in the St. Cesaire Neanderthal.

The St. Césaire 1 Neanderthal skeleton of a young adult individual is unique in its association with Châtelperronian artifacts from a level dated to ca. 36,000 years ago. Computer-tomographic imaging and computer-assisted reconstruction of the skull revealed a healed fracture in the cranial vault. When paleopathological and forensic diagnostic standards are applied, the bony scar bears direct evidence for the impact of a sharp implement, which was presumably directed toward the individual during an act of interpersonal violence. These findings add to the evidence that Neanderthals used implements not only for hunting and food processing, but also in other behavioral contexts. It is hypothesized that the high intra-group damage potential inherent to weapons might have represented a major factor during the evolution of hominid social behavior.

Animals↗
PubMed1994

Epidemiology of the rheumatic diseases.

Understanding, description, and classification of musculoskeletal pain syndromes have been further substantiated, but linking them to physical and psychological variables remains problematic. Core tools to measure disability in a population context forms a stable, well validated set of instruments, which increasingly has been translated, tested, and applied in sociocultural settings and in outcome research. Evidence for a declining incidence of rheumatoid arthritis seems established, and paleopathologic evidence indirectly provides some support for a possible causative environmental agent. Within an epidemiologic framework, immunogenetic studies continue to suggest an increasing number of subsets of rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis variants. Studies in which the overuse hypothesis was tested as a cause in the etiology of osteoarthritis have provided conflicting results. Increasing evidence shows a secular trend in loss of bone mineral density, resulting in an increased fracture incidence. However, validated methods to safely prevent osteoporosis and fracture are also being established. Finally, although they are now well recognized and scientifically productive, large long-term epidemiologic studies should be critically examined.

Persons with Disabilities↗
PubMed1998

Diseases of the skull in pre-Columbian South American mummies.

OBJECTIVE: The majority of paleopathological investigations focus on the study of the skull. This is because the skull is the most frequently preserved part of the human body recovered from archaeological excavations. From studying the skull, a variety of information can be obtained regarding the individual, such as sex, age, nutritional status, and other disease processes, if present. METHODS: This study represents the examination of more than 700 human skulls recovered from archaeological excavations from the Andean region of southern Peru and northern Chile and dating back more than 8000 years. RESULTS: A variety of skull abnormalities were encountered. The nonmetric variables of Huschke's foramina and palatine tori were common. Cranial deformation was observed in more than 85% of the cases. There were two cases of sagittal synostosis. Iron deficiency anemia resulting in porotic hyperostosis of the skull was evident in certain cultures. Exostoses of the external auditory canal resulting from chronic otitis was evident only among coastal populations. One skull demonstrated a periostitis consistent with Treponema infection. Trephination was encountered only in the skulls from Peru. Fifty-four cases of skull fractures were observed, half of which showed evidence of healing. Finally, only two cases of neoplastic skull lesions were encountered. CONCLUSION: The study of the human skull alone provides a large amount of information regarding the health and diseases of ancient populations.

Adult↗
PubMed1978

Age determination of an Alaskan mummy: morphological and biochemical correlation.

Aspartic acid racemization analysis of a tooth from an Alaskan mummy yielded an age at death of 53 (+/- 5) years, which correlates well with earlier estimates based on morphological features. This study illustrates the value of integrative approaches to paleopathologic problems and the importance of preserving rare specimens for the application of new techniques.

Aspartic Acid↗