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PLoS Pathog. 2018 May 10;14(5):e1006997. doi: 10.1371/journal.ppat.1006997. eCollection 2018 May.

Ancient genomes reveal a high diversity of Mycobacterium leprae in medieval Europe.

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Institute for Archaeological Sciences, University of Tübingen, Tübingen, Germany.
Senckenberg Centre for Human Evolution and Palaeoenvironment, University of Tübingen, Tübingen, Germany.
Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.
Global Health Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany.
Department of Archaeogenetics, Max Planck Institute for the Science of Human History, Jena, Germany.
Center for Bioinformatics, University of Tübingen, Tübingen, Germany.
McDonald Institute for Archaeological Research, University of Cambridge, Cambridge, United Kingdom.
Unit of Anthropology (ADBOU), Department of Forensic Medicine, University of Southern Denmark, Odense S, Denmark.
Department of Microbial Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.
Department of Microbiology and Biotechnology Centre, The Maharaja Sayajirao University of Baroda, Vadodara, India.
Department of Anthropology, National Museum, Prague, Czech Republic.
Department of Archaeology of Landscape and Archaeobiology, Institute of Archaeology of the Czech Academy of Sciences, Prague, Czech Republic.
Department of Biological Anthropology, University of Szeged, Szeged, Hungary.
Department of Biological, Geological and Environmental Sciences, Bologna, Italy.
ADES AMU-CNRS- EFS: Anthropology and Health, Aix-Marseille Université, Marseille, France.
Department of Biology, University of Florence, Firenze, Italy.
Historic England, Portsmouth, United Kingdom.
Centre for Clinical Microbiology, Division of Infection and Immunity, University College London, London, United Kingdom.
Department of Archaeology, University of Southampton, Southampton, United Kingdom.
Institut Pasteur, Paris, France.


Studying ancient DNA allows us to retrace the evolutionary history of human pathogens, such as Mycobacterium leprae, the main causative agent of leprosy. Leprosy is one of the oldest recorded and most stigmatizing diseases in human history. The disease was prevalent in Europe until the 16th century and is still endemic in many countries with over 200,000 new cases reported annually. Previous worldwide studies on modern and European medieval M. leprae genomes revealed that they cluster into several distinct branches of which two were present in medieval Northwestern Europe. In this study, we analyzed 10 new medieval M. leprae genomes including the so far oldest M. leprae genome from one of the earliest known cases of leprosy in the United Kingdom-a skeleton from the Great Chesterford cemetery with a calibrated age of 415-545 C.E. This dataset provides a genetic time transect of M. leprae diversity in Europe over the past 1500 years. We find M. leprae strains from four distinct branches to be present in the Early Medieval Period, and strains from three different branches were detected within a single cemetery from the High Medieval Period. Altogether these findings suggest a higher genetic diversity of M. leprae strains in medieval Europe at various time points than previously assumed. The resulting more complex picture of the past phylogeography of leprosy in Europe impacts current phylogeographical models of M. leprae dissemination. It suggests alternative models for the past spread of leprosy such as a wide spread prevalence of strains from different branches in Eurasia already in Antiquity or maybe even an origin in Western Eurasia. Furthermore, these results highlight how studying ancient M. leprae strains improves understanding the history of leprosy worldwide.

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