Genetic diseases are a significant concern today, affecting one in every 25 children born worldwide. These conditions can range from mild to severe, and often have lasting effects on a person’s health and quality of life. However, what is less understood is the evolutionary history of these diseases. Which genetic disorders were prevalent in our ancestors, and why did they persist? Even more intriguing is whether these conditions are still present in the modern human population.
In a recent study, my colleague and I uncovered one of the earliest known common genetic conditions in human evolution, identified in a species of early hominin called Paranthropus robustus. This species lived around 2 million years ago and exhibited a particular genetic disorder that caused severe dental defects. These defects, known as pitting enamel hypoplasia, were a result of a condition called amelogenesis imperfecta. The affected individuals had teeth covered in small, circular pits, giving them a distinctly abnormal appearance, resembling a golf ball’s dimpled surface.
The discovery of this condition in P. robustus provides fascinating insight into the health of our ancient ancestors. Fossils of P. robustus have been found in abundance across several South African caves, located within the “Cradle of Humankind,” about 50 kilometers northwest of Johannesburg. Although most of these fossils consist of isolated teeth and jaw fragments, some remarkably well-preserved skulls and bones offer a rare glimpse into the morphology and lives of these hominins.
The Paranthropus genus, to which P. robustus belongs, is a crucial part of the human evolutionary tree. These hominins were characterized by their large molars and massive jaws, which were thought to have evolved to process a diet consisting primarily of tough, fibrous vegetation. In some Paranthropus species, individuals had prominent sagittal crests—ridges of bone running along the top of the skull—believed to serve as anchors for their powerful jaw muscles. These adaptations highlight the remarkable evolutionary journey of Paranthropus, an early group that played a significant role in our distant past.
Identifying genetic diseases in fossil records is inherently difficult. Over time, DNA degrades, and it becomes increasingly challenging to extract usable genetic material from specimens that are tens of thousands or even millions of years old. Once DNA is no longer available, researchers must rely on the physical evidence left in bones and teeth, which limits the types of genetic conditions that can be identified. Even with the growing collection of hominin fossils, it remains a challenge to detect genetic disorders, especially when those conditions may have been rare or subtle in the population.
However, despite these challenges, the frequency of certain genetic conditions can still be detected in the fossil record if those conditions were widespread among a population. The discovery of amelogenesis imperfecta in P. robustus adds to our growing understanding of the types of genetic diseases that affected ancient hominins.
Amelogenesis imperfecta is a condition that affects the enamel of teeth, causing defects in its structure. Today, it occurs in about 1 in 1,000 individuals. However, our study of P. robustus has revealed that it was much more common in this species. Of several hundred P. robustus teeth analyzed, over half of the baby molars exhibited pitting enamel defects, and around a quarter of adult molars showed similar issues. Moreover, evidence suggests that other species within the Paranthropus genus also experienced this genetic disorder.

This condition likely had a significant impact on the diet and overall survival of P. robustus. Severe enamel defects can lead to extreme tooth wear, dental cavities, and difficulty chewing food. The high rate of dental disease observed in P. robustus teeth, with cavities forming in the pitted areas of enamel, is a direct consequence of this condition. In modern times, amelogenesis imperfecta is often a cosmetic issue, as advancements in dental care can mitigate the effects. However, in P. robustus, the condition would have had a much more profound impact on their ability to feed and thrive.
The question arises: why did this condition persist in P. robustus and related species for over a million years? If it had such negative consequences on survival, why was it so prevalent? The answer likely lies in the rapid evolution of Paranthropus and its focus on developing large molars. This rapid evolutionary pressure to increase tooth size could have led to genetic instability in the associated genes, which could then have caused unintended side effects in other traits—what is known as pleiotropy.
Pleiotropy occurs when one gene affects multiple traits, which can result in a genetic trade-off. In the case of P. robustus, the genes responsible for the development of large, thick enamel and robust molars may have inadvertently led to defects in tooth enamel, such as those seen in amelogenesis imperfecta. One such gene, ENAM, is involved in enamel formation and is associated with the development of enamel thickness. Mutations in this gene are known to cause amelogenesis imperfecta. The evolutionary pressure for larger teeth may have inadvertently caused mutations in this gene, making the enamel more prone to defects, which resulted in the high frequency of pitting enamel hypoplasia in P. robustus.

Despite the disadvantages associated with amelogenesis imperfecta, it seems that the benefits of having large, robust teeth were greater. These teeth allowed P. robustus to process a diet rich in tough plant material, a dietary adaptation that likely contributed to their survival. The trade-off between large teeth and enamel defects may have been seen as worthwhile by natural selection, as evidenced by the widespread success of Paranthropus species. They survived for hundreds of thousands of years, even alongside early members of the genus Homo, further suggesting that their evolutionary adaptations were well-suited to their environment.
This discovery has significant implications not only for understanding the health and biology of ancient hominins but also for shedding light on the history of genetic disease. By studying the genetic conditions found in ancient species like P. robustus, we can gain valuable insights into the genetic roots of conditions like amelogenesis imperfecta in modern humans. Furthermore, the discovery opens up the possibility that other genetic disorders, which are rarely identified in the fossil record, could be found in future studies of hominin remains. As DNA analysis techniques continue to improve and more fossils are uncovered, it is likely that additional rare genetic conditions will be identified, offering further clues to the genetic history of our ancestors.
Source: The Conversation