The ability of microbial pathogens to target specific cell types is a key aspect of the pathogenesis of infectious disease. Mycobacterium leprae, by infecting Schwann cells, contributes to nerve injury in patients with leprosy. Here, we investigated mechanisms of host-pathogen interaction in the peripheral nerve lesions of leprosy. We found that the expression of the C-type lectin, CD209, known to be expressed on tissue macrophages and to mediate the uptake of M. leprae, was present on Schwann cells, colocalizing with the Schwann cell marker, CNPase (2,3-cyclic nucleotide 3-phosphodiesterase), along with the M. leprae antigen PGL-1 in the peripheral nerve biopsy specimens. In vitro, human CD209-positive Schwann cells, both from primary cultures and a long-term line, have a higher binding of M. leprae compared to CD209-negative Schwann cells. Interleukin-4, known to be expressed in skin lesions from multibacillary patients, increased CD209 expression on human Schwann cells and subsequent Schwann cell binding to M. leprae, whereas Th1 cytokines did not induce CD209 expression on these cells. Therefore, the regulated expression of CD209 represents a common mechanism by which Schwann cells and macrophages bind and take up M. leprae, contributing to the pathogenesis of leprosy.The interaction between a microbial pathogen and distinct host cells is a crucial step in the initiation of the immune response and also contributes to the pathogenesis of the disease. In the human disease leprosy, the pathogen Mycobacterium leprae infects at least two cell types, macrophages and Schwann cells, both contributing to disease pathogenesis. The mechanism of Schwann cell infection includes interaction of M. leprae-specific phenolic glycolipid 1 (PGL-1) with laminin 2 in Schwann cell basal lamina and also with the ERBB2 receptor on the cell surface of Schwann cells (36). Infection of Schwann cells by M. leprae contributes to inflammation in leprosy, involving antigen presentation and Toll-like receptor (TLR)-mediated cytokine release (24, 32). The uptake of M. leprae by Schwann cells results in demyelination and subsequent nerve damage in leprosy, a major cause of patient morbidity (35).In contrast to the receptors that mediate uptake of M. leprae by Schwann cells, macrophages use a distinct set of cell surface receptors to facilitate phagocytosis. Among these is the C-type lectin receptor, CD209, also known as DC-SIGN (dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin), which mediates recognition of several pathogens, including viruses, fungi, and bacteria (8). CD209 facilitates cell binding to several species of mycobacteria, including M. tuberculosis, M. bovis, and M. leprae (9,20,30). The recognition of mycobacteria by CD209 has been shown to be mediated by interaction with the mycobacterial mannose-capped lipoarabinomannan (Man-LAM) (9). Although originally identified on in vitro-derived dendritic cells (DCs), CD209 is expressed by macrophages in leprosy lesions and was shown to be required for optim...