Granulomatous hypersensitivity induced by sensory peripheral nerve


THE nature of granulomas remains uncertain. In sarcoidosis and Crohn's disease of the ileum, the aetiology is unknown. Even where a causative organism has been identified, as in tuberculosis and non-lepromatous leprosy, the role the mycobacteria play in the development of the granuloma is obscure1. There is no animal model available for the study of granulomatous hypersensitivity. But in susceptible human subjects it is possible to produce granulomas with tubercle formation by skin testing with zirconium2 or beryllium3. Similarly, in sarcoidosis, granulomas with tubercles occur in patients skin-tested with Kveim antigen (sarcoid spleen or lymph node suspension). These reactions are specific for each antigen and independent of dose. Thus, chronic states of altered tissue reactivity or granulomatous hypersensitivity can be found in humans4. We have shown that rabbits develop skin lesions after injection with homogenates of peripheral sensory nerve5. Now we report that these lesions sometimes possess organised granulomas in tubercles, and that similar granulomas can be produced by skin-testing rabbits sensitised with sensory nerve, using cutaneous nerve as the challenging antigen. These results suggest that granulomas may sometimes be an autoimmune response to tissue antigens: in the case of non-lepromatous leprosy, to an antigen in peripheral nerve containing sensory fibres5. A specific diagnostic test for leprosy is therefore a possibility.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.


  1. 1

    Epstein, W. L., Prog. Allergy, 11, 36–38 (1967).

  2. 2

    Shelley, W. B., and Hurley, H. J., Nature, 180, 1060–1061 (1957).

  3. 3

    Sneddon, I. B., Br. med. J., 1448–1450 (1955).

  4. 4

    Epstein, W. L., Adv. Biol. Skin, 11, 313–336 (1971).

  5. 5

    Crawford, C. L., Evans, D. H. L., and Evans, E. M., Nature, 251, 223–5 (1974).

  6. 6

    Elias, P. M., and Epstein, W. L., Am. J. Path., 52, 1207–1223 (1968).

  7. 7

    Allt, G., Evans, E. M., and Evans, D. H. L., Brain. Res., 29, 271–191 (1971).

  8. 8

    Black, M. M., and Epstein, W. L., Am. J. Path., 74, 263–274 (1974).

  9. 9

    Robbins, S. L., Pathology, 750 (Saunders, Philadelphia, 1967).

  10. 10

    Putkonen, T., Acta derm. vener., Suppl. 10 180–184, (1943).

  11. 11

    Siltzbach, L. E., and Ehrlich, J. C., Am. J. Med., 16, 790–803 (1954).

  12. 12

    Mitchell, D. N., and Rees, R. J. W., Lancet, ii, 81–84 (1969).

  13. 13

    Mitchell, D. N., and Rees, R. J. W., Lancet, ii, 168–171 (1970).

  14. 14

    Cave, D. R., Mitchell, D. N., Kane, S. P., and Brooke, B. N., Lancet, ii, 1120–1122 (1973).

  15. 15

    Taub, R. N., Sacher, D., Siltzbach, L. E., and Janowitch, H., Trans. Ass. Am. Physns, 87, 219–224 (1974).

  16. 16

    Bolton, P. H., Owen, E., Heatley, R. V., Jones Williams, W., and Hughes, L. E., Lancet, ii, 1122–1124 (1973).

  17. 17

    Gitnick, G. L., Arthur, M. H., and Shibata, I., Lancet, ii, 215–217 (1976).

Download references

Author information

Rights and permissions

Reprints and Permissions

About this article

Cite this article

CRAWFORD, C., HARDWICKE, P., EVANS, D. et al. Granulomatous hypersensitivity induced by sensory peripheral nerve. Nature 265, 457–459 (1977).

Download citation

Further reading


By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.