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Background: IgG4-related disease (IgG4-RD) is a systemic condition of unknown etiology, characterized by highly fibrotic lesions with dense lymphoplasmacytic infiltrates rich in IgG4+ plasma cells and CD4+ T cells (1). Given the longstanding history of atopy that characterizes a proportion of patients with IgG4-RD, it has been suggested that TH2 cytokines contribute to the pathogenesis of this condition (2). However, we recently demonstrated that allergic manifestations are not increased in patients with IgG4-RD compared to the general population (3). Similarly, CD4+TH2 cells are expanded only in the peripheral blood of IgG4-RD patients with concomitant atopy, questioning the hypothesis of IgG4-RD as a TH2 driven condition (4). Objectives: We aimed to characterize CD4+ T cell subsets in IgG4-RD subjects. Methods: We used flow cytometry to identify CD4+ effector/memory T cells as well as Th1, Th2, and T regulatory cells in a cohort of 101 IgG4-RD patients. Gene expression analysis was used to further characterize expanded cells. Results were validated by flow cytometry. Next-generation sequencing of the T cell receptor β chain gene was performed on CD4+ T cells in a subset of patients to identify their clonality. Tissue infiltration by specific T cells was examined using quantitative multi-color imaging. Results: CD4+ effector/memory T cells with a cytolytic phenotype (cytotoxic T lymphocytes (CTLs)) were expanded in IgG4-RD patients compared to healthy controls. Next-generation sequencing revealed prominent clonal expansions of these CD4+CTLs but not of CD4+GATA3+ memory TH2 cells in subjects with IgG4-RD. The dominant T cells infiltrating a range of inflamed IgG4-RD tissue sites were clonally expanded CD4+CTLs that expressed granzyme A and perforin. Clinical remission induced by rituximab-mediated B cell depletion was associated with a reduction in disease-associated CD4+ CTLs. Conclusions: IgG4-RD is prominently linked to clonally-expanded CD4+ CTLs in peripheral blood as well as in inflammatory tissue lesions. A TH2 signature might be primarily linked to a concomitant atopic diathesis. CD4+ CTLs might be of pathogenic importance in other fibrotic conditions including IgG4-RD.

Gandhiists, scholarly and otherwise, have consistently manipulated ‘the Mahatma image’ in accounting for M.K. Gandhi's role as a social and political ‘revolutionary’ and as the founder of ‘non‐violent resistance’. Uncritically assuming a consistent, virtually uninterrupted continuity between Mahatma Gandhi at the height of his career in India and M.K. Gandhi's career as a social and political reformer in Natal and the Transvaal (1893–1914), Gandhiists have systematically suppressed evidence which problematises their historiographical practice and ‘the Mahatma image’. In this paper I argue that Gandhi's practices in South Africa, particularly those resulting from his editorship of Indian Opinion, were often discontinuous with and even contradictory to the soothing fiction of ‘the Mahatma image’, but were at the same time significant factors in the genealogy of Satyagraha.

A reproducible technique for stinging guinea pigs with Chrysaora quinquecirrha has been described. A linear urticarial eruption which persists for approximately 24 hours appears within two to four hours. Motionless jellyfish tentacles must be in contact with the skin more than 15 seconds to produce an eruption. This interval can be shortened by moving the tentacle. The amount of petrolatum necessary to prevent the eruption was quantitated and appears to be inversely related to motion of the tentacle. The incorporation of strong base or polysorbate 20 at suprathreshold concentrations increased the blocking efficiency of petrolatum. Unfortunately, because the former agent produces irritation and the latter washes out of the ointment, these compounds are not acceptable blockers. A silicone containing form of stopcock grease was also an effective blocking agent, however, its use will be limited since it cannot be easily removed from the skin.