The 82nd Annual Meeting of the American Association of Physical Anthropologists (2013)


Co-occurrence of tuberculosis and an unusual rheumatoid-like arthritis in prehistoric Central California

ELAINE M. BURKE1, RESHMA E. VARGHESE2, EMILY A. BULGER3, CAITLIN L. IBARRA4, HILLARY M. OJEDA5, REBECCA S. JABBOUR6 and GARY D. RICHARDS7.

1Molecular and Cell Biology, University of California, Berkeley, 2Public Health, University of California, Berkeley, 3Integrative Biology, University of California, Berkeley, 4Anthropology, California State University East Bay, 5Anthropology, University of California, Berkeley, 6Biology, Saint Mary's College of California, 7Biomedical Sciences, A.A. Dugoni School of Dentistry, University of the Pacific

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Assessment of skeletons from the Hotchkiss Mound (CCo-138) has produced the first evidence of prehistoric tuberculosis on the West Coast. It has also revealed an unusually high incidence of severe, symmetrical, polyarticular arthritis. Tuberculosis infection directly impacts bones and joints. In addition, genetic conditions that result in bone-joint pathology can be accentuated by the introduction of Mycobacterium tuberculosis. We hypothesize that a causal link exists between these two conditions and provide a preliminary assessment of our findings.

We examined skeletal remains and compiled observations from a pathology database for the California collection, Phoebe Hearst Museum of Anthropology, UC Berkeley (n=2570). A paleoepidemiological profile was established for the CCo-138 population (n=793). We identified three cases of tuberculosis, all deriving from the CCo-138 locality. Pathologies were identified in 52% of adults and 13% of subadults. Of the adults assignable to a time phase, the frequency of arthritis ranges from 73-100% for adults. Tuberculosis lesions have been identified only in the final two phases.

Joint pathology in the CCo-138 population resembles rheumatoid arthritis, but there is extensive spinal involvement similar to that in advanced cases of osteoarthritis. The incidence and degree of joint destruction is unmatched in any other California locality. We suggest that a genetic condition underlies the observed joint disease and that this destructive condition was accentuated by a cell-mediated response to the bacterium, as occurs in Poncet’s disease. Further work on this population may clarify issues related to the pre-European occurrence of rheumatoid arthritis in Native Americans.

Funding provided by Undergraduate Opportunity Fund Grants to: EMB, REV, EAB, and HMO.

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