Importance of the neural predilection of Mycobacterium leprae in leprosy.

It is suggested that continuous leakage of bacilli into the circulation from a primary focus of intraneural infection may simultaneously initiate bacillary dissemination and the suppression of cell-mediated immunity. Both these features are essential for the development of lepromatous leprosy. Nerve involvement in leprosy, previously thought of as a diagnostic feature of the disease and as a complication of therapy, may represent an essential phase in the cycle of infection and reinfection by Mycobacterium leprae.