title: Mycolic acids and ancient DNA confirm an osteological diagnosis of tuberculosis.
abstract: METHODS
  The underlying trends in the past epidemiology of tuberculosis (TB) are obscure, requiring recourse to the archaeological record. It would therefore be of value to develop methods for reliable TB diagnosis in ancient populations.
  
  
  OBJECTIVE
  To test the capability of two biomarkers, Mycobacterium tuberculosis complex mycolic acids and a DNA target (IS6110), for confirming an osteological diagnosis of TB in medieval individuals, based on the presence of Pott's disease and/or rib lesions.
  
  
  METHODS
  Osteological examination of three archaeological individuals (Medieval: approximately 1000 years old) revealed a Pott's disease case, one with no changes consistent with TB and one with rib lesions. Rib samples from these individuals were examined for the presence of Mycobacterium tuberculosis complex mycolic acids and mycobacterial DNA.
  
  
  RESULTS
  Mycobacterium tuberculosis complex mycolic acids and the DNA target were detected in the Pott's disease case, whilst mycolic acids (insufficient for confirmation) alone were detected in the rib lesion case.
  
  
  CONCLUSIONS
  Biomarkers provide a sensitive tool to detect ancient TB. Mycobacterium tuberculosis DNA is not distributed homogeneously, making multiple sampling essential. Mycolic acids seem more reliable for ancient TB diagnosis than IS6110. The demonstrated stability of mycolic acids show that they may be of value in tracing the palaeoepidemiology of tuberculosis back into antiquity.
authors.affiliation: Fossil Fuels and Environmental Geochemistry, Department of Chemistry, University of Newcastle, Newcastle upon Tyne NE1 7RU, UK. namg1@talkZ1.com
authors.forename: A M
authors.initials: AM
authors.lastname: Gernaey
authors.forename: D E
authors.initials: DE
authors.lastname: Minnikin
authors.forename: M S
authors.initials: MS
authors.lastname: Copley
authors.forename: R A
authors.initials: RA
authors.lastname: Dixon
authors.forename: J C
authors.initials: JC
authors.lastname: Middleton
authors.forename: C A
authors.initials: CA
authors.lastname: Roberts
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D002851:Chromatography, High Pressure Liquid; D004269:DNA, Bacterial / Q000032:analysis*; D049691:History, Medieval; D006801:Humans; D008297:Male; D009169:Mycobacterium tuberculosis / Q000737:chemistry*; D009171:Mycolic Acids / Q000032:analysis*; D010164:Paleopathology; D016133:Polymerase Chain Reaction / Q000379:methods; D012272:Ribs / Q000382:microbiology; D014394:Tuberculosis, Osteoarticular / Q000175:diagnosis* / Q000266:history; D014399:Tuberculosis, Spinal / Q000175:diagnosis / Q000266:history
chemical_list: D015415:Biomarkers; D004269:DNA, Bacterial; D009171:Mycolic Acids