Revision of tuberculous lesions in the Bácsalmás-Óalmás series - preliminary morphological and biomolecular studies

Abstract

Previous investigations carried out in some parts of the 16th-17th century AD series of Bácsalmás-Oalmás (southern Hungary) have already provided interesting paleopathological cases of tuberculosis (e.g. Molnár & Pálfi 1994). These studies were essentially based on macromorphological analysis, biomolecular methods were used only in a few cases (e.g. Haas et al. 2000). From a macromorphological point of view, former investigations have only considered 'classical' tuberculosis (TB) alterations (advanced-stage lesions in common skeletal locations). However, due to the recent development of diagnostic criteria in the field of the paleopathology of infectious diseases, new approaches have been introduced in the identification of skeletal TB lesions (Pálfi et al. 1999, Maczel 2003). Molecular methods for the detection of mycobacterial aDNA have also been developed considerably in the last few years (e.g. Donoghue 2008, Donoghue 2011). The good state of preservation of the material, the important chronological period of the series and the relative high prevalence of TB reported in preliminary studies encouraged us to carry out a revision of TB-related lesions in the complete Bácsalmás-Oalmás series. A five year international research program--including both macroscopic and biomolecular studies of the series--was recently started. The present paper summarizes the results ofa pilot project conducted to optimize the further systematic paleopathological and paleomicrobial studies. Skeletal material of 205 individuals was chosen forthe macromorphological test-investigation, which was focused both on classical/advanced stage skeletal TB alterations (tuberculous spondylitis, tuberculous arthritis) and atypical/early-stage TB lesions (rib lesions, superficial vertebral changes, endocranial alterations, early-stage spondylodiscitis). In addition, the association of possible stress factors (long bone periostitis, cribra orbitalia, cribra cranii) were also considered. Paleomicrobiological analysis was used to study the presence of Mycobacterium tuberculosis ancient DNA (aDNA) in morphologically positive and negative cases. A comparative paleomicrobial analysis was carried out on different samples, to test the presence of MTB DNA in different skeletal regions.

Morphological and biomolecular evidence for tuberculosis in 8th century AD skeletons from Bélmegyer-Csömöki domb, Hungary

“…Positive correlations between tuberculosis and stress indicators, such as long boné periostitis, cribra orbitatia and cribra cranii, were alsó recognized [7,8]. Since the 1990s, the identification of skeletal tuberculosis in ancient humán remains has been facilitated by the confirmation of atypical or early-stage TB lesions by new biomolecular methods based on mycobacterial ancient DNA (aDNA) and lipid biomarker analyses [1,[9][10][11][12].…”

Langerhans cell histiocytosis or tuberculosis on a medieval child (Oppidum de la Granède, Millau, France – 10th–11th centuries AD)

“…Other criteria match the diagnosis: the young age of the individual, plurifocal and pluriostotic lytic lesions, the cranial location [61], punched out lytic lesions, and the presence of sequestrum [57]. SES [54] has been associated with TB based on morphological observations [63,64] validated by molecular biology [65,66] as a result of TB leptomeningitis. Cranial location is uncommonly predominant in TB [67], and facial bones should be more affected than the cranial vault.…”

Ancient pathogens in museal dry bone specimens: analysis of paleocytology and aDNA

“…Previous studies on microbes within historical bone tissue mainly focussed on the remnants of microbial activity [32,36], the pathologic lesions caused by microbial infection [68,83], or the identification of ancient DNA (aDNA) from pathogens [30,33,58]. However, recent studies on histopathology of historical dry bone provide organic, more 1 3 precisely cellular, bacterial and fungal evidence [16,17,64,71].…”

“…A molecular approach on paleodiseases such as leprosy [30,78], tuberculosis [25,58], and the plague [33,87] by detection of bacterial ancient DNA (aDNA) has been repeatedly successful. Ancient DNA research on treponematoses has nevertheless proven difficult.…”