Macrophages phagocytoseMycobacterium leprae and live bacilli inside such macrophages alter the lipid metabolism. There is increased accumulation of cholesterol ester in the bacteria infected cells. This increase appears to be due to the decreased level of esterase enzyme that could hydrolyse cholesterol esters. Associated with decreased level of this enzyme is the reduced amount of protein synthesis. Increased cholesterol ester may be responsible for conversion of macrophages into foamy cells in the presence ofM. leprae.