Paul Langerhans Jr. — the man behind two medical eponyms

Recognition for Langerhans’ two major medical discoveries was awarded posthumously.

Issue: July 2008

Some people might say that Paul Langerhans Jr. was destined to make many contributions to medicine because he was born into a family of physicians and scientists.

He made his first major contribution even before he finished medical school. This was the discovery of epidermal nonpigmentary dendritic cells that are derived from the bone marrow and play a role in cell-mediated immunity. The importance of these cells was a mystery at first. However, their importance was identified more than a century later.

Second, Langerhans made the first detailed description of the pancreas. Specifically, he described a group of nine different types of cells that later became known as the islets de Langerhans.

Early life

Paul Wilhelm Heinrich Langerhans was born in Berlin on July 25, 1847. He was the first son of Dr. Paul August Herrmann Langerhans, a well-respected physician in Berlin, and Anna Luise Caroline Langerhans, née Keibel.

His mother was a cousin of the embryologist Franz Karl Julius Keibel. His parents had two daughters before his mother died of tuberculosis in 1853. His father remarried and had two more sons, both of whom also became involved in medicine.

In 1865, just two weeks after graduation from high school, Langerhans went on to the University of Jena, where he studied medicine for three semesters under Ernst Haeckel. He continued his medical studies at the University of Berlin, where he was a student of Julius Cohnheim and Rudolf Virchow.

Langerhans cells

In 1867, Langerhans made his first critical discovery while he was still a medical student and working at Virchow’s laboratory at the Berlin Pathological Institute. He used Cohnheim’s gold chloride staining technique to describe nonpigmentary dendritic cells found in the epidermis.

This discovery was described in a paper that was published in 1868 in Virchow’s Archiv. The title of the paper was “On the Nerves of the Human Skin.”

Initially, he thought these cells were intraepidermal receptors for extracutaneous signals of the nervous system. However, in a paper published later in 1882, he recognized that the cells were not necessary for nerve endings.

More than a century later in 1973, Inga Silberberg discovered that cells are derived from promonocytes in the bone marrow, represent the most peripheral outpost of the human immune system and play a role in delayed hypersensitivity. They were named Langerhans cells. The proliferation of the cells is also known as Langerhans cell histiocytosis. The cells are the best studied immature dendritic set.

Islets de Langerhans

Focal hemorrhage in the islets of Langerhans.

Source: CDC

Langerhans began experimental work for his thesis in 1867 but abandoned the project to compete for the University of Faculty medicine prize. He won the prize for a study of tactile corpuscles in diseases of the skin and central nervous system. He then returned to work on his thesis, which would lead to his second discovery: the islets of Langerhans.

Prior to his thesis, histologic knowledge of the pancreas was limited. For his thesis, Langerhans described nine different cells in the pancreas. Two of the cells were surely new. One type were spindle-shaped centroacinar glandular cells that secreted digestive enzymes.

These cells were scattered with another cell type with a polygonal structure, and the cells were found together in large numbers. Langerhans found no name or function for the cells. But about 25 years later, Edouard Laguesse, a French histophysiologist, found similar cells in the pancreas.

Laguesse identified the cells as those that Langerhans described in his 1869 thesis, “Contributions to the Microscopic Anatomy of the Pancreas.” Laguesse named the cells the islets de Langerhans and hypothesized that these cells were the site of internal secretion. In 1909, the term insulin was introduced.

Professorship and war

After completing his thesis, he stayed in Virchow’s laboratory for another year. In collaboration with Friedrich Hoffman, he demonstrated that cinnabar was taken up by the white blood corpuscles but not the red. This study led to future concepts of the reticuloendothelial system.

In September 1870, Langerhans began a one-year service as a physician in the army during the Franco-Prussian war. One year later, he became an assistant professor of pathology at the University of Freiburg. There he continued his studies despite a full teaching load.

He became a full professor in 1874, but just a few weeks later, he was diagnosed with renal tuberculosis. He requested a six-month leave of absence to recover but continued to work on studies involving the anatomy of marine animals. He requested an extension of his leave in 1875 but was released from his duties at the university until complete recovery.

Studies in Madeira

While on leave from the university, he traveled to Madeira. It was here that he discovered a new research interest: fauna of Atlantic islands, including Madeira. He did research on marine worms that received 2,000 gold marks from the Berlin Academy.

After one year, he was free of fever but did not return to Germany until 1878. His condition had deteriorated, however, so he resigned from the University of Freiburg. He then returned south and spent time on Tenerife. He wrote several papers on the worm fauna of Madeira. These contributions resulted in several polychaete worms being named for him.

His health improved to the point where he could practice medicine on Madeira. Most of his patients had come to the island for health reasons, most suffering from tuberculosis. Langerhans took an interest in the disease and published two papers on tuberculosis. The first dealt with the etiology of phthisis and was published in 1884.

Legerhans died on July 20, 1888, five days before his 41st birthday. – by Emily Shafer

For more information:

Campbell WR. Paul Langerhans, 1847-1888. CMAJ. 1958;79:855-856.

Jolles S. Paul Langerhans. J Clin Pathol. 2002;55:243.

Sakula A. Paul Langerhans (1847-1888): a centenary tribute. J R Soc Med. 1988;81:414-415.

Egeler RM, Zntinga AR, Coppes MJ. Paul Langerhans Jr. (1847-1888): A short life, yet two eponymic legacies. Med Pediatr Oncol. 1994;22:129-132.