China's tuberculosis epidemic stems from historical expansion of four strains of Mycobacterium tuberculosis. Issue 12 (December 2018)

• Record Type: Journal Article
• Authors: Liu, Qingyun; Ma, Aijing; Wei, Lanhai; Pang, Yu; Wu, Beibei; Luo, Tao; Zhou, Yang; Zheng, Hong-Xiang; Jiang, Qi; Gan, Mingyu; Zuo, Tianyu; Liu, Mei; Yang, Chongguang; Jin, Li; Comas, Iñaki; Gagneux, Sebastien; Zhao, Yanlin; Pepperell, Caitlin; Gao, Qian
• Is Part Of: Nature ecology & evolution. Volume 2:Issue 12(2018)
• Page Start: 1982
• Page End: 1992
• Publication Date: 2018-12
• Subjects: Ecology -- Periodicals; Evolution (Biology) -- Periodicals; 577.05
• DOI: 10.1038/s41559-018-0680-6
• Languages: English
• ISSNs: 2397-334X

Abstract

Abstract A small number of high-burden countries account for the majority of tuberculosis cases worldwide. Detailed data are lacking from these regions. To explore the evolutionary history of Mycobacterium tuberculosis in China—the country with the third highest tuberculosis burden—we analysed a countrywide collection of 4, 578 isolates. Little genetic diversity was detected, with 99.4% of the bacterial population belonging to lineage 2 and three sublineages of lineage 4. The deeply rooted phylogenetic positions and geographic restriction of these four genotypes indicate that their populations expanded in situ following a small number of introductions to China. Coalescent analyses suggest that these bacterial subpopulations emerged in China around 1, 000 years ago, and expanded in parallel from the twelfth century onwards, and that the whole population peaked in the late eighteenth century. More recently, sublineage L2.3, which is indigenous to China and exhibited relatively high transmissibility and extensive global dissemination, came to dominate the population dynamics of M. tuberculosis in China. Our results indicate that historical expansion of four M. tuberculosis strains shaped the current tuberculosis epidemic in China, and highlight the long-term genetic continuity of the indigenous M. tuberculosis population. Analysis of 4, 578 Mycobacterium tuberculosis isolates reveals the evolutionary history of the four tuberculosis genotypes in China, from emergence 1, 000 years ago to expansion, population peaks and, more recently, dominance of the indigenous sublineage L2.3.