Growth of Legionella pneumophila within human monocytes is iron dependent. A person with monocytes uniquely nonpermissive to L. pneumophila growth was identified whose monocytes expressed an abnormally low number of transferrin receptors in the nonactivated state, similar to the typically low level expressed in the interferon-gamma-activated state. The monocytes failed to up-regulate transferrin receptor expression appropriately in response to iron-transferrin. After treatment for chronic periodontal disease, the subject's monocytes converted to a permissive state. In contrast to the nonpermissive state, the permissive monocytes had normal transferrin receptor expression and up-regulated transferrin receptor expression appropriately in response to iron-transferrin. Thus, a nonpermissive state for L. pneumophila intracellular multiplication is associated with low levels of transferrin receptor expression in nonactivated monocytes and with an inability to up-regulate transferrin receptor expression in response to iron-transferrin. This nonpermissive state may be related to chronic inflammatory conditions such as periodontal disease.