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Using a population genetic model parameterized with historical demographic and epidemiological data, we show that neither cholera nor typhoid fever provided enough historical selective pressure to produce the modern incidence of cystic fibrosis. However, we demonstrate that the European tuberculosis pandemic beginning in the seventeenth century would have provided sufficient historical, geographically appropriate selective pressure under conservative assumptions. Tuberculosis has been underappreciated as a possible selective agent in producing cystic fibrosis but has clinical, molecular and now historical, geographical and epidemiological support. Implications for the future trajectory of cystic fibrosis are discussed. Our result supports the importance of novel investigations into the role of arylsulphatase B deficiency in cystic fibrosis and tuberculosis.<\/jats:p>","DOI":"10.1098\/rsif.2006.0154","type":"journal-article","created":{"date-parts":[[2006,9,7]],"date-time":"2006-09-07T16:50:25Z","timestamp":1157647825000},"page":"91-98","source":"Crossref","is-referenced-by-count":62,"title":["Evaluating candidate agents of selective pressure for cystic fibrosis"],"prefix":"10.1098","volume":"4","author":[{"given":"Eric M","family":"Poolman","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Public Health, Yale University School of Medicine60 College Street, Room 147, New Haven, CT 06520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison P","family":"Galvani","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Yale University School of Medicine60 College Street, Room 147, New Haven, CT 06520, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"175","published-online":{"date-parts":[[2006,9,5]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"crossref","first-page":"3458","DOI":"10.1128\/JCM.37.11.3458-3464.1999","article-title":"Case-control study of enteropathogens associated with childhood diarrhea in Dhaka, Bangladesh","volume":"37","author":"Albert M.J","year":"1999","journal-title":"J. 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