SYNOPSIS Our recent work focused on some immunological aspects of CH patients. We found a decrease in the expression of HLA‐B14 antigen on lymphocytes of these patients. In previous studies, we showed that testosterone plasma levels are low in these patients during the crises. It is possible to postulate a correlation between the variation of some hormonal parameter and changes of circulating leukocytes subsets (as in pregnancy and in the pre‐eclamptic syndrome). The following lymphocyte and monocyte subsets were studied using the monoclonal antibodies of Becton Dickinson series: Leu1 +, Leu2+, Leu3a+, Leu7+, Leu10+, ratio helper/ suppressor, LeuM3 +. We compared, using the ANOVA test, the values obtained during a phase of headache crisis versus those obtained out of crisis. A significant increase in lymphocyte subset Leu7+ (20.9±2.5 vs. 13.8±1.1, p<0.05) and in monocyte subset LeuM3 + (26.3 ± 1.4 vs. 20.8 ± 1.2, p<0.05) was observed during the phase of crisis.
In a previous study we demonstrated that cluster headache (CH) patients present an increased Natural Cytotoxic response after incubation of their peripheral blood lymphocytes (PBL) with Interleukin-2 (IL-2). This phenomenon led to an investigation of the phenotypic expression of PBL before and after IL-2 incubation, and of the IL-2 lymphocyte receptor. IL-2 receptor is expressed on T-lymphocytes activated with an high-affinity binding site. The analysis of the function of human IL-2 receptor was facilitated by the production of a specific monoclonal antibody (MAb). This MAb identifies the IL-2 receptors by blocking the binding of radiolabelled IL-2 to T-cells. In addition, we studied the expression of Leu-4, specific for T-cells; of Leu-11b, specific for FC receptor on NK cells; and the Transferrin Receptor, specific for lymphoblasts and monocytes. Twenty-three episodic CH patients were selected for this study. Ten sex and age-matched healthy volunteers were used as the control group. We evaluated the PBL phenotypic expression of cells subsets before incubation with IL-2 (1,000 I.U./ml) and after 72 hours. The following Becton Dickinson MAbs have been used: anti-Leu-4 (CD3), anti-IL-2 receptors (CD25), anti-Transferrin receptor (TFR) and anti-Leu-11b (CD16). Indirect fluorescence with a Becton Dickinson FACS-420 flow cytometer was used to analyze the cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Previous studies showed that the Natural Killer (NK) activity of peripheral blood lymphocytes (PBL) from cluster headache (CH) patients is lower than that of controls. This decreased activity seems to be independent of the cluster period. beta-interferon has been shown to be more effective in increasing NK activity when incubated with PBL from CH patients, than with PBL from control donors. Lymphokine-Activated Killer (LAK) cells can be generated by incubation of human PBL in recombinant Interleukin-2 (rIL-2). This phenomenon was studied in 10 CH patients and 8 healthy volunteers. PBL were activated to LAK cells by "in vitro" incubation for 72 hours in Control Medium containing rIL-2 (1000 I.U./ml). A four hour Chromium 51 release was used to measure LAK Cell Killing of K562 target cells. The released radioactivity was measured in a gamma scintillation counter. The CH patients showed a marked increase of LAK generation compared to control subjects. This effect seems to be augmented during the cluster period.
SYNOPSIS The relationship between the major system of histocompatibility antigens and cluster headache has already been studied by our group, and decreased frequency of HLA‐B14 antigen shown in cluster headache patients in comparison to a control population. The therapy of cluster headache with lithium salts is already widely acclaimed; nevertheless there are patients who derive no benefit or must suspend treatment due to side‐effects. Thus we wanted to study the relationship between genetic markers of patients with the illness and the therapeutic efficacy of lithium salts. 35 episodic cluster headaches have been studied; they had been already typed for the HLA antigens. The patients were treated with lithium carbonate for a period of 3 months. As parameters for evaluation of the efficacy of treatment, the headache index ratio, the wake‐sleep rhythm and the pupil diameter measurement were studied. Statistical evaluation was made and it was possible to separate two subgroups of patients: “responders” and “non responders” to lithium therapy. The phenotypical frequencies in the two subgroups was analyzed using the X2 test. A higher frequency of HLA‐B18 antigen (23.8% vs 0%; p< 0.0005; pc<0.06) and of HLA‐A9 antigen (42.9% vs 14.3%) showed in the “responders” group. In the “non responders” group was found a higher frequency in HLA‐A1 antigen (35.7% vs 14.3%).
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