Joël Blondiaux

Two Roman and medieval cases of symmetrical erosive polyarthropathy from Normandy: anatomico-pathological and radiological evidence for rheumatoid arthritis

With continued archaeological discoveries of skeletal remains in the USA and Europe, discussion of the possible aetiology for recognized cases of symmetrical erosive polyarthropathy include the spondylarthropathies and rheumatoid arthritis. One skeleton from the fourth century site of Lisieux and a second from the eleventh century site of Rouen are characterized by numerous symmetrical marginal erosions, primarily involving the metacarpophalangeal and proximal interphalangeal joints. Results of maroscopic, microscopic and radiological examination are highly suggestive of a modern-day diagnosis of rheumatoid arthritis. These data are consistent with the presence of rheumatoid arthritis before the onset of the fourteenth century.

Addressing Therapeutic Options for Ebola Virus Infection in Current and Future Outbreaks

ABSTRACT Ebola virus can cause severe hemorrhagic disease with high fatality rates. Currently, no specific therapeutic agent or vaccine has been approved for treatment and prevention of Ebola virus infection of humans. Although the number of Ebola cases has fallen in the last few weeks, multiple outbreaks of Ebola virus infection and the likelihood of future exposure highlight the need for development and rapid evaluation of pre- and postexposure treatments. Here, we briefly review the existing and future options for anti-Ebola therapy, based on the data coming from rare clinical reports, studies on animals, and results from in vitro models. We also project the mechanistic hypotheses of several potential drugs against Ebola virus, including small-molecule-based drugs, which are under development and being tested in animal models or in vitro using various cell types. Our paper discusses strategies toward identifying and testing anti-Ebola virus properties of known and medically approved drugs, especially those that can limit the pathological inflammatory response in Ebola patients and thereby provide protection from mortality. We underline the importance of developing combinational therapy for better treatment outcomes for Ebola patients.

Bilateral fractures of the scapula: Possible archeological examples of beatings from Europe, Africa and America

Traumatic injuries to the scapula have received little attention in the paleopathological literature. They are rarely encountered in medical emergencies today due to the overlying muscles that protect the bone; they comprise just 1% of all fractures. This collaborative project brings together five cases of bilateral fractures of the scapulae in four ancient populations from three different time periods and three continents (France, Sudan and USA). It is thus an opportunity to interpret bilateral scapula fracture etiology by suggesting a cause that could have been present in all contexts, namely direct trauma such as might take place during beating with heavy sticks or other blunt force weapons. We also argue that oval defects with rounded margins in scapular bodies are less likely to be congenital anatomical variants than the result of healed trauma.

The impact of periodontal disease on cementochronology age estimation

Estimating an individuals age at death is essential for post-mortem identification, paleopathology and paleodemography. With substantial development over the past 10 years in cementochronology analyses, some concerns have arisen that oral pathological conditions may artificially reduce or increase cementum apposition. The objective of this study was to observed the impact of periodontal disease on acellular cementum and on the reliability of cementochronology to test its accuracy for estimating individual age at death. The study included 41 teeth presenting different degrees of bone destruction, extracted from 18 individuals affected by untreated periodontal disease. The results demonstrated that the degree of alveolysis had only limited effects on the counting of cementum annulations in the middle (rp=0.92, p<0.01 between estimated and civil age) and the cervical (rp=0.85, p<0.01) thirds of the root, whereas in the apical third, the increments were affected considerably. This cementum reactive process compensates for bone destruction and loss of the attachment apparatus. These data suggest that cementum could continue to grow at a slower rate despite bone destruction due to periodontal disease. Cementochronology can thus be applied to teeth with a damaged periodontium by sectioning the middle third of the root.

Tuberculosis and survival in past populations: A paleo-epidemiological appraisal

Historical assessments of the last two centuries consistently placed tuberculosis as the leading cause of mortality. However, for earlier periods, we can only calculate the frequencies of archaeological bone lesions, which tell us little about the real impact of the disease on mortality. These lesions are usually observed in individuals who have developed immune resistance, which is visible as healed osteo-articular lesions. This study aimed to test the differential impacts of tuberculosis, cribra orbitalia and cribra femoris on adult survival and sex-based survival. We analyzed 28 French adult samples from the Antiquity and the Early Middle Ages. The age-at-death of 1480 individuals was estimated using cementochronology. Survival curves and median age-at-death were calculated to test new hypotheses that challenge the parasitic and deficiency theories of bone stress markers. Comparisons between carriers and non-carriers provided new information concerning the plausible causes of bone stress markers related to infections and TB. The most likely hypothesis is skeletal demineralization and osteoclastic resorption, which are usually observed close to tubercular granuloma or distant from active lesions. The bone marrow niche of Mycobacterium tuberculosis within CD271(+) BM-MSCs stem cells is the proposed explanation for the localized cortical resorption that is observed in bone stress markers.

Cementochronology and sex: A reappraisal of sex-associated differences in survival in past French societies

The objective of the present study is to test our general knowledge of sex-specific survival differences in past northern France societies by implementing the tooth cementum annulations method of age estimation (i.e., cementochronology) to bio-archaeological series. 1255 individual estimated ages at death covering a millennium from the 3rd c. AD to the 15th c. AD matched different patterns of sex mortality from the late Antiquity to the Late Middle Age. Female survival curves are consistently inferior to those of their male counterparts. Maternal mortality is clearly visible in survival curves between 20 and 50 years of age in individual sites and pooled samples. Variations of sex mortalities also affected sites with peculiar recruitment, such as religious communities, pathological samples, leprosaria, and migrants. Whisker plots of median ages at death variations confirmed in both sex that populations within the Early Middle Ages were better off compared to Late Antiquity and Late Medieval Ages when group inequalities prevailed. Due to its sensitivity and applicability to small samples, cementochronology should be extended to other series.

Comportements alimentaires en Gaule du Nord : étude isotopique du site de l’Îlot de la Boucherie (IIIe–Ve siècles apr. J.-C.) à Amiens

RésuméL’analyse des comportements alimentaires constitue un indicateur permettant d’approcher les transformations des modes de vie ou encore les processus d’acculturation des populations au cours du temps. C’est notamment dans le contexte particulier de la Gaule du Nord, entre le IIIe siècle et le début du ve siècle apr. J.-C., qu’une étude des pratiques alimentaires a été entreprise afin de cerner l’impact de la romanisation sur ces habitudes. Cette étude propose de contribuer à cette question par l’analyse des isotopes stables du carbone et de l’azote (δ13C et δ15N) contenus dans les phases organique et minérale des dents et des os de sujets adultes provenant du site de l’Îlot de la Boucherie à Amiens (Somme). Les objectifs sont de définir le régime alimentaire et de décrire son évolution au cours de la vie des individus. Les sujets échantillonnés (n = 33) forment un groupe aux habitudes alimentaires peu disparates qui ne varient pas entre l’enfance et l’âge adulte. La comparaison des valeurs de δ13C entre les sujets humains et les animaux domestiques (n = 28) met en évidence un enrichissement important en 13C dans les tissus humains lié soit à la consommation d’une ressource de type C4 comme le millet, soit à celle de ressources marines de faible niveau trophique (fruits de mer). Les valeurs de δ15N des humains relativement basses laissent supposer une alimentation contenant peu de protéines animales. Le régime alimentaire décrit pour cette population se distingue des résultats publiés pour le reste de l’Empire romain.AbstractAnalyses of dietary patterns can provide indications on changing lifestyles and acculturation processes in populations over time. In this study, focusing on the specific context of northern Gaul between the third and the early fifth century AD, we attempted to identify the impact of Roman culture on dietary patterns. The aim was to contribute to this research question by analysing the stable carbon and nitrogen isotopes (δ13C and δ15N) contained in the organic and inorganic phases of the teeth and bones of adult subjects from the Îlot de la Boucherie site in Amiens (Somme, Northern France) defining the contemporary diet and how it evolved over the lifetime of individuals. The subjects sampled (N = 33) form a homogenous group regarding their diet, with no significant variation between childhood and adulthood. A comparison of δ13C values in humans and domestic animals (N = 28) showed that the human tissues were significantly richer in 13C, reflecting the consumption of either a type C4 resource such as millet or sea food resources at a low level in the food chain, such as shellfish. The relatively low δ15N values in the human sample suggest a diet containing little animal protein. The diet thus described in this population differs from the results published for the rest of the Roman Empire.

Aux origines de la maladie osseuse de Paget. Un nouveau cas néolithique dans le sud de la France

RésuméParmi les ossements recueillis dans une grotte sépulcrale du sud de la France, nous avons reconnu un cas de maladie de Paget polyostotique. La datation C14, après calibration, donne un âge d’environ 3350 ans avant J.-C. Après la description macroscopique, radiologique et microscopique de ces pièces, nous rapportons les éléments de la révision des deux cas les plus anciens publiés auparavant. Ces cas concernent des individus ayant vécu en Europe entre la fin du Néolithique et le Chalcolithique. Il est donc avéré que la maladie de Paget était déjà présente à cette époque, et au sud de l’Europe occidentale; aucun cas plus ancien n’a été signalé à ce jour.AbstractAmong the commingled bones collected in a sepulchral cave in southern France, we recognized a case of polyostotic Paget’s disease of bone (PDB). The C14 dating, after calibration, was 3350 BC. After the macroscopic description, the microscopic and radiological analyses of these samples, we discuss the criteria for a re-examination of the two oldest cases previously published. Both cases concern individuals who lived in Europe between the end of the Neolithic period and the Chalcolithic period. Thus, it can be established that PDB was already present at that period and in south-western Europe; no older case has been reported to date.