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QIMR In search of a treatment strategy for scabies

‘We strive to answer some important questions at a global level. Such as: does scabies alter the microbiota of healthy skin? Which bacteria are present in scabies lesions? Does the scabies mite function as a carrier of bacterial pathogens? We aim to determine the diversity and dynamics of microbes associated with human scabies across a range of geographical and economic environments. This will lead to the first comprehensive worldwide snapshot of this disease-complex. We hope to identify the molecular mechanisms that underlie the synergy between mites and bacteria. How they work together to overcome the host’s immune system.’

1 | How many people are infected with scabies worldwide and why is this research so important?
‘About 300 million people are infected worldwide. As a consequence, scabies is one of the most common dermatological infectious diseases. The WHO recognised scabies as a neglected tropical disease in 2017. Particularly in tropical climates, scabies infections can lead to serious bacterial diseases that can be potentially life-threatening. In the more isolated areas of northern Australia, more than half of Aboriginal children have scabies. They are 12 times more likely to develop the scabies-related impetigo than children in urban settings, a factor that contributes to a high frequency of rheumatic fever and heart disease. Furthermore, scabies results in a poor quality of life due to stigmatisation. Scabies and its associated secondary infections are not often counted as serious diseases, and yet they cause high levels of morbidity and mortality worldwide. To address this disease-complex, more research is urgently needed.’

2 | Have you already received the relevant ethical approvals for research?
‘Some ethical applications were already approved before we received the grant, other ethical applications are still pending. Once we have all the necessary ethical approvals, we can start collecting skin samples.’

3 | In which countries do you collect skin samples?
‘We are taking samples in France, India, Australia, French Guiana and possibly more countries. Whenever we sample scabies lesions, it is highly likely that we capture both the microbiota of mites and of the skin around the mite. We also take control samples of healthy skin from each patient at all times.’

4 | Naturally, the analysis follows the data collection, but what do you expect to find?
‘We strive to answer some important questions at a global level. Such as: does scabies alter the microbiota of healthy skin? Which bacteria are present in scabies lesions? Does the scabies mite function as a carrier of bacterial pathogens? We aim to determine the diversity and dynamics of microbes associated with human scabies across a range of geographical and economic environments. This will lead to the first comprehensive worldwide snapshot of this complex disease. We hope to identify the molecular mechanisms that underlie the synergy between mites and bacteria. How they work together to overcome the host’s immune system.’

5 | What is the ultimate goal of the project?
‘We hope to be able to understand the diversity and dynamics of the microbes associated with human scabies. The research will provide the basic molecular data for translational research into more effective prevention, management and treatment strategies for scabies and the associated impetigo. Which in turn, is the stepping stone towards improved treatment and management strategies of the disease.’

Multidisciplinary and international team

The research involves an international and multidisciplinary team. The main disciplines and institutes are:
dermatologists from Hôpital Henri Mondor, Université Paris-Est, Créteil, France; dermatologists and microbiologists from Seth G.S. Medical College and K.E.M Hospital, Mumbai, India; dermatologists in North Queensland, Australia; molecular parasitologists from QIMR Berghofer Medical Research Institute, Brisbane, Australia; bioinformaticians from QIMR Berghofer Medical Research Institute.