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New findings in cluster headache.

M Giacovazzo1

  • 1Cattedra di Patologia Speciale Medica e Metodologia Clinica VI, Università degli Studi, Roma La Sapienza, Italy.

Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna
|July 1, 1990
PubMed
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Cluster headache, or Horton's histaminic headache, may stem from periodic immune oversight. Research links specific HLA antigens and immune markers to headache severity and lithium response.

Area of Science:

  • Neurology
  • Immunology
  • Genetics

Background:

  • Cluster headache, known as Horton's histaminic headache in Italy, is an excruciating pain syndrome predominantly affecting men.
  • Existing pathogenetic theories for cluster headache are reviewed.

Purpose of the Study:

  • To investigate the immunological and genetic factors potentially underlying cluster headache.
  • To explore the relationship between specific human leukocyte antigen (HLA) types and patient response to lithium therapy.

Main Methods:

  • Analysis of human leukocyte antigen (HLA) frequencies, including HLA-B14, HLA-DR5, and HLA-B18.
  • Measurement of serum antibody titers, alpha 1-antitrypsin levels, IgE (PRIST) values, and circulating immune complexes (C1qSp, KgBt).
  • Evaluation of cellular immunity, including leukocyte subpopulations (Leu7+, Leu M3+) and natural killer cell function, alongside antibody titers against herpes simplex viruses and Epstein-Barr virus.

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Main Results:

  • A low frequency of HLA-B14 and a high frequency of HLA-DR5 were observed.
  • HLA-B18 presence correlated with positive response to lithium therapy, while its absence was noted in non-responders.
  • Elevated antibody titers during painful periods, decreased alpha 1-antitrypsin, increased IgE, high circulating immune complexes, increased Leu7+ and Leu M3+ cells, low natural killer function, and high titers of anti-herpes simplex and anti-Epstein-Barr virus antibodies were found.

Conclusions:

  • Cluster headache may be characterized by a periodic lack of immune oversight.
  • Specific genetic markers (HLA antigens) and immune dysregulations are associated with cluster headache and its treatment response.