Tobacco and Tuberculosis in the Past, Present, and Future: a Bioarchaeology of People, Products, and Pathogens

通过烟草使用的镜头，本奖学金的第一部分展示了生物考古学对当前健康辩论的价值。后来，第2部分对这种方法进行了扩展，并探索了人类结核病的共同进化。烟草在后中世纪时期(16-19世纪)主要被商品化，为政府和精英阶层创造财富，今天人们知道烟草显著改变了具有社会意义的疾病的模式和流行。然而，在健康的社会历史中，烟草使用并不被考虑。这错过了研究过去不那么直接影响健康的因素的机会，例如社会政治和烟草商品化，以及生物考古学对当今最紧迫的公共健康问题的贡献。骨骼在生活中不断地适应，化学和物理上的，反映消费的产品，环境和疾病。因此，对过去人的遗骸的研究揭示了变化，包括新的行为和社会优先事项，如何影响我们。这项研究的第一部分以比较的方法使用骨骼遗骸来研究烟草在三个不同的后中世纪社会到来后疾病模式是如何变化的。它研究了这一时期的重要疾病(结核病、维生素D缺乏、牙病和癌症)，这些疾病都已知因今天的烟草使用而加剧。通过将疾病模式与烟草使用和商品化的历史来源联系起来，我们可以评估商品化如何影响健康。此外，通过使用前现代个体(1900年代以前)，我们可以开始将烟草与其他现代生活变量(污染、家庭吸烟和抗生素)在疾病病因和表现中的作用分开。基于莱斯特大学考古和古代史学院(UOL)，该项目使用了来自三个不同烟草历史地区的900具骨架：英国，主要是烟斗吸烟的主要烟草生产国；荷兰，英国烟草的进口国，主要是烟斗吸烟者；以及西班牙，鼻烟、雪茄和香烟的进口国和使用者。与UOL的遗传学和基因组生物学部门以及塔尔图大学基因组研究所合作，生物分子方法，包括遗传和蛋白质组(蛋白质)，将补充疾病分析(古病理学)的宏观方法，以概念化疾病模式。利用代谢组学的一种新的生物分子方法将与UOL的精密医疗诊断研究所一起开发，以改进对过去个人烟草使用和暴露的检测。代谢组学是一种研究生物样本中所有小分子的生化方法。对这些分子的分析使研究人员能够在包括骨骼和牙齿在内的生物材料中识别药物使用或疾病的独特指标(生物标记物)。它在这里的发展和应用将是考古骨骼的第一个，并为第二部分的研究奠定基础，我们的目标是提供对结核病动态变化的洞察。由于公众对考古学的巨大兴趣，一个展览、播客和一个在线教学资源将提高对烟草在发展慢性疾病中的作用的理解，这些疾病不太为人所知，吸烟会加剧这种疾病。这些举措在防止吸烟方面很有价值，这是许多卫生机构的优先事项，并提高了人们的生活质量。将成立一个以考古遗迹为重点的跨学科工作组，并通过开放获取、出版物和会议介绍等方式传播信息。总体而言，在探索烟草商品化如何改变过去群体中的疾病，以及结核病模式如何随着时间的推移而改变的过程中，该奖学金将展示生物考古学的力量，为过去人、文化行为和健康之间的复杂动态提供独特的见解，并提供给当今意义重大的当代健康辩论。

Through the lens of tobacco use, Part 1 of this fellowship demonstrates the value of Bioarchaeology for current health debates. Later, part 2 expands on this approach and explores human tuberculosis co-evolution. Tobacco, mostly commodified to generate wealth for governments and elites in the post-medieval period (16th-19th centuries), is known today to significantly alter the patterns and prevalence of socially significant diseases. Yet, tobacco use is not considered in social histories of health. This misses a chance to examine less direct dictators of health in the past, e.g. sociopolitics and commodification of tobacco, and for Bioarchaeology to contribute to one of today's most pressing public health issues.Bone constantly adapts in life, chemically and physically, reflecting consumed products, environment, and disease. Thus, research on the remains of past people reveal how changes, including new behaviours and social priorities, impact us. Part 1 of this fellowship uses skeletal remains in a comparative approach to examine how disease patterns changed after the arrival of tobacco in three different post-medieval societies. It examines important diseases of the period (tuberculosis, vitamin D deficiency, dental disease, and cancer) all known to be exacerbated by tobacco use today. By contextualising disease patterns with historical sources on tobacco use and commodification, we can assess how commodification impacted health. Additionally, in using pre-modern individuals (pre 1900s) we can begin to disentangle the role of tobacco from other modern life variables (pollution, domestic smoke, and antibiotics) in disease causation and expression.Based at the School of Archaeology and Ancient History (University of Leicester (UoL)), this project uses 900 skeletons from three regions of differing tobacco history: England, major tobacco producers and mainly pipe smoking; the Netherlands, importers of English tobacco and mainly pipe smokers; and Spain, importers and users of snuff, cigars and cigarettes. Working with the UoL's Department of Genetics and Genome Biology and the Institute of Genomics at the University of Tartu, biomolecular methods, including genetic and proteomic (proteins), will complement macroscopic methods for disease analysis (palaeopathology) to conceptualise disease patterns. A novel biomolecular approach using metabolomics will be developed with the UoL's Precision Medical Diagnostic Institute to improve detection of tobacco use and exposure in past individuals. Metabolomics is a biochemical method that studies all small molecules in a biological sample. Analysis of these molecules permits researchers to identify distinctive indicators (biomarkers) of drug use or disease in biological material, including bone and teeth. Its development and application here would be the first on archaeological bone, and sets up the foundations for research in part 2 where we aim to provide insight into changing TB dynamics. Due to tremendous public interest in archaeology, an exhibition, podcasts, and an online teaching resource will improve understandings of the role of tobacco in developing chronic diseases less well known to be exacerbated by smoking. Such initiatives are valuable in preventing the uptake of smoking, a priority for many health agencies, and improving people's life quality. An interdisciplinary working group focusing centred on archaeological remains will be formed and information disseminated through open access publication and conference presentation. Overall, in exploring how tobacco commodification altered disease in past groups, and how TB patterns change overtime, this fellowship will demonstrate Bioarchaeology's power to provide unique insights into the complex dynamics between people, cultural behaviours and health in the past, and feed into contemporary health debates of significance today.