Rash associated with familial
Mediterranean fever (Wikicommons – Dr. H.J. Lachman)
In the eastern Mediterranean, people
were likelier to survive bubonic plague if they had stronger inflammatory
responses to infection in their lungs, gut, and other tissues. Today, that
natural selection is attested by a high incidence of familial Mediterranean
fever.
Familial Mediterranean fever
is due to mutations that increase the body’s production of pyrin, a protein
that assists inflammatory responses to infection of the lungs, gut, and other
tissues. It’s common among eastern Mediterranean peoples, like Jews, Syrians,
Armenians, Turks, Greeks, and Italians. The most common symptoms are
inflammation of the abdominal lining, the joints, and the chest. Some kind of
natural selection seems likely because different mutations have evolved
independently to produce the same disease within the same geographic region.
Several years ago, Greg
Cochran suggested this fever might be an adaptation to trypanosome parasites
(Leishmaniasis). Recent research now suggests an adaptation to bacteria of the
genus Yersinia. Y. pestis causes bubonic plague, whereas Y. pseudotuberculosis and Y. enterocolitica cause gastroenteritis. These pathogens are highly
infectious because they decrease the body’s production of pyrin and thus reduce
its ability to fight infection. To compensate for this underproduction of
pyrin, there seems to have been selection for mutations that cause overproduction
of pyrin, hence the high incidence of familial Mediterranean fever in populations
that have coexisted with Yersinia
bacteria (Loeven et al. 2020).
Yepiskoposyan and Harutyunyan
(2007) argue that selection for familial Mediterranean fever must have begun
more than 2,500 years ago, since one of the alleles responsible for it is found
in different communities of the Jewish diaspora, notably Iraqi and North
African Jews. That argument doesn’t convince me, since diaspora communities were
not reproductively isolated. The mutation could have arisen in one community
and then been spread to others by Jewish individuals moving from one place to
another.
I’m inclined to believe that
selection for this fever began with the earliest recorded outbreak of bubonic
plague: the Plague of Justinian (541-549 AD), which killed an estimated 25
million people throughout the Mediterranean Basin and the Middle East. An
earlier date is nonetheless possible, since Y.
pestis has been attested in archaeological finds as far back as 5,000 years
ago (Wikipedia 2022).
References
Chung, L.K., Y.H. Park, Y. Zheng, I.E. Brodsky, P. Hearing, D.L. Kastner, J.J. Chae, and J.B. Bliska. (2016). The Yersinia Virulence Factor YopM Hijacks Host Kinases to Inhibit Type III Effector-Triggered Activation of the Pyrin Inflammasome. Cell Host Microbe 20(3):296-306. https://doi.org/10.1016%2Fj.chom.2016.07.018
Cochran, G. (2015). Familial Mediterranean fever. West Hunter, January 9. https://westhunt.wordpress.com/2015/01/09/familial-mediterranean-fever/
Loeven, N.A., N.P. Medici, and J.B. Bliska. (2020). The pyrin inflammasome in host-microbe interactions. Curr Opin Microbiol 54:77-86. https://doi.org/10.1016/j.mib.2020.01.005
Wikipedia (2022). Bubonic plague. https://en.wikipedia.org/wiki/Bubonic_plague#History
Yepiskoposyan, L., and A.
Harutyunyan. (2007) Population genetics of familial Mediterranean fever: a
review. Eur J Hum Genet 15: 911–916.
https://doi.org/10.1038/sj.ejhg.5201869
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