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At least 2 million people worldwide are afflicted with leprosy, yet very little is known about the pathogenesis of the disease, which attacks the nerves of the hands, feet and face and, if left untreated can take away the ability to move fingers, toes and eyelids.

Researchers have assumed that the vigorous immune response that follows infection by the Mycobacterium leprae bacteria that cause leprosy is what leads to the nerve damage in patients.

Instead, Anura Rambukkana from the Rockefeller University in New York and colleagues have found that the bacteria directly cause the nerve damage. M. leprae infects a certain type of so-called Schwann cells, which help protect and support the nerve cells.

Because some Schwann cells proliferate in response to nerve injury, the authors propose that M. leprae damages nerves in order to generate more cells to occupy.

The findings — published in the 3 May issue of Science — may open the door to new ways to treat the disease.

Reference: Science 296, 927 (2002)