IntroductionThe existence of polarised human T cell responses, reminiscent of the TH1 and TH2 subsets already described for mouse T cells, is well documented [1]. TH1 and TH2 responses not only play different roles in protection, but they can also promote different immunopathological reactions.TH1 cells produce interferon (IFN)-γ, interleukin (IL)-2 and tumour necrosis factor beta. On the other hand, TH2 cells release interleukin-4, IL-5, IL-6, IL-9, IL-10 and IL-13 [2]. TH1 cells are responsible for cell-mediated immune responses, for macrophage activation in terms of antibodydependent cell cytotoxicity (ADCC) and for delayed-type hypersensitivity (DTH). TH2 cells provide optimal help for humoral immune responses. These include IgE and IgG isotype switching, mucosal immunity through activation of mast cells and eosinophils, and facilitation to IgA synthesis [3]. Human TH1 and TH2 cells differ not only in their different lymphokine secretion profiles, but also in their responsivenesses to lymphokines. Both TH1 and TH2 cells proliferate in response to interleukin-2, but TH2 are much more responsive to IL-4 than are TH1 cells [4]. IFN-γ plays a selective inhibitory effect on the proliferative response of TH2 cells [5]. Moreover, human TH1 cells preferentially develop during infections by intracellular bacteria, protozoa and viruses [6, 7], whereas TH2 cells predominate during helminthic infections [8] and in response to common environmental allergens.TH1 and TH2 type cytokines are mutually inhibitory for the differentiation and the effector functions of the reciprocal phenotypes. Thus, a strong TH2-oriented response tends to downregulate TH1-type responses and vice versa [9]. A wide variety of infections and autoimmune diseases is characterised by responses that are strongly polarised to either TH1 or TH2 patterns of cytokine secretion. Abstract T lymphocytes participate not only in immune responses but also in the development of several pathologic reactions. Human T helper cells, on the basis of the cytokines they release, fall into two phenotypes, namely TH1 and TH2. The aim of the present research was to assess whether T lymphocytes are involved in cluster headache pathogenesis. We studied 12 cluster headache patients and 6 control cases in terms of T lymphocyte subsets and their related cytokine release. Our results show that during a cluster headache attack, the TH1 subset is activated, whereas in the periods between and out of the crisis, the TH2 cells become predominant. The possible role played by T lymphocytes and cytokines in the biomolecular phenomenon leading to cluster headache is discussed.