You’ve heard it: “Dupuytren is a ‘Viking disease’.” Is it?
The answer begins in 1985. That year, surgeon John Hueston published his second textbook on Dupuytren disease. He wrote this on the first page of Chapter 6:
That the Celtic immigration has spread this ‘Viking disease’ across the north of Europe, where the highest incidence is in Iceland, but that in Sweden is matched in Edinburgh and the centres of British migration such as Canada and Australia, still demonstrates the Viking invasions as the most decisive factor in the distribution of this condition.
This was the first time the words “Dupuytren” and “Viking” had been officially connected in print. It was a different time, when surgeons wrote in a conversational style, seamlessly blending experiences and opinions with facts, not jargon-filled, number-heavy sentences. This was the first time Dupuytren had been described as a “Viking disease”, something which has since been repeated over and over – and over. I’ve counted 113 medical journal articles published since 1985 which associate Dupuytren with the Vikings. Viking legacy makes a great story. It sounds believable. It’s also a complete fantasy. Hueston knew that Dupuytren is common in those with a European heritage. He also knew that Vikings had traveled across Europe. He connected the dots. In theory. There’s been no data to confirm or deny this popular theory – until now.
Ng and colleagues just published research on this topic in the European Journal of Hand Surgery. They studied populations in geographic areas of the British Isles differing in percent Nordic ancestry. They used computational analysis to compare known differences in ancestry with a genetic risk score for Dupuytren based on variations in 21 genes. They write:
In conclusion, our genetic analyses directly contradict the widely held belief, especially popular among patients, that DD is a disease of Norse origin.
What does this change? It changes the way we do Dupuytren research. Rather than trying to solve a complex problem by peeking through the keyhole of personal experience and gut feeling, we need to embrace new data and new tools. Genetic analysis continues to evolve. The data used for Ng’s study was based on genotyping: sampling a set number of genes. The Dupuytren Research Group’s Blood Biomarker Discovery pilot study will use next-generation whole-exome sequencing to identify 100 times as many genes as genotyping and will measure age-related and other dynamic effects (“whole-genome DNA methylation”) in 5000 times as many genes as Ng could study.
It’s happening very fast. We are at the right place at the right time to make real breakthroughs in understanding Dupuytren biology and to make real progress toward a cure. If you haven’t signed up for our International Dupuytren Data Bank research study, now is the time:
If you want to speed up the process, now is the time to support this research:
Charles Eaton MD
Source: Ng M, Lawson DJ, Winney B, Furniss D. Is Dupuytren’s disease really a “disease of the Vikings”? J Hand Surg Eur Vol. October 2019, doi:10.1177/1753193419882851 (PDF)