Rheumatic disease and the Australian Aborigine

Abstract

Objective-To document the frequency and disease phenotype of various rheumatic diseases in the Australian Aborigine. Methods-A comprehensive review was performed of the archaeological, ethnohistorical, and contemporary literature relating to rheumatic diseases in these indigenous people. Results-No evidence was found to suggest that rheumatoid arthritis (RA), ankylosing spondylitis (AS), or gout occurred in Aborigines before or during the early stages of white settlement of Australia. Part of the explanation for the absence of these disorders in this indigenous group may relate to the scarcity of predisposing genetic elements, for example, shared rheumatoid epitope for RA, B27 antigen for AS. In contrast, osteoarthritis appeared to be common particularly involving the temporomandibular joint, right elbow and knees and, most probably, was related to excessive joint loading in their hunter gatherer lifestyle. Since white settlement, high frequency rates for rheumatic fever, systemic lupus erythematosus, and pyogenic arthritis have been observed and there are now scanty reports of the emergence of RA and gout in these original Australians. Conclusion-The occurrence and phenotype of various rheumatic disorders in Australian Aborigines is distinctive but with recent changes in diet, lifestyle, and continuing genetic admixture may be undergoing change. An examination of rheumatic diseases in Australian Aborigines and its changing phenotype may lead to a greater understanding of the aetiopathogenesis of these disorders.

Focus on systemic lupus erythematosus in Indigenous Australians: towards a better understanding of autoimmune diseases

“…35 Other studies have suggested a high prevalence of interracial marriage among IA with RA, 36,37 but in contrast, in a recent unselected population survey, no case of RA was reported in IA. 38 Genetics might explain a low prevalence of RA in IA, as IA rarely harbour the rheumatoid major histocompatibility complex class II shared epitope.…”

“…46 Personal observations of antineutrophil cytoplasmic antibody-related vasculitis and dermatomyositis have been reported in IA. 37 There are no published data on the prevalence of primary Sjögren Syndrome, autoimmune thyroiditis, coeliac disease, vitiligo or psoriasis in IA.…”

Epidemiology of Spondyloarthritis

“…In Iraq a prevalence was reported of 0.07% [70] and in Iran of 0.14 [71]. For Australia, there is no evidence to support the occurrence of AS in the indigenous Australian Aborigines with pure ancestry, probably related to the very low frequency of HLA-B27 in this population [72]. Studies from Latin-America and Africa are scarce.…”

New developments in the epidemiology and genetics of gout

“…Detailed genetic studies on the Ayatal tribe of Taiwanese Aborigines have recently been performed and are described below. Other Aboriginal populations that have been studied include Australian Aborigines, in whom the occurrence of gouty arthritis was originally reported to be rare [26,27], although the prevalence of hyperuricemia was reported to be higher in Aboriginals compared with non-Aboriginals [28]. A recent report by Chan and Segasothy [29], however, suggests that gout may be more common than previously thought in this native population.…”