Immune Imbalance Model of Classical Scabies in a Boarding School Setting: Evidence from Th17–Treg–Related Biomarkers and Clinical Severity
Keywords:
Foxp3, IL-17, IL-10, Immune imbalance, Lesion extent, Recurrence, Recurrence frequency, Th17–Treg axisAbstract
Background: Scabies remains a significant public health concern in communal living environments, where recurrence and variable lesion severity frequently occur. The imbalance between pro-inflammatory and regulatory immune responses, particularly within the Th17–Treg axis, may influence disease expression. Objective: This study aimed to evaluate the association between Th17–Treg–related biomarkers (IL-17, IL-10, and FoxP3) and clinical severity indicators in adolescents with classical scabies. Methods: An explanatory cross-sectional study was conducted among 24 adolescents diagnosed with classical scabies based on International Alliance for the Control of Scabies criteria. Serum IL-17, IL-10, and FoxP3 levels were measured using ELISA. Clinical severity was assessed based on lesion extent and recurrence frequency. Correlation analyses were performed to determine associations between immune biomarkers and clinical outcomes. Results: IL-17 levels were significantly inversely correlated with recurrence (r= –0.483, p=0.017) and lesion extent (r= –0.460, p=0.024). Conversely, IL-10 and FoxP3 levels were positively associated with recurrence and lesion severity, with FoxP3 demonstrating the strongest correlation with lesion extent (r=0.690, p<0.001). No significant associations were observed between demographic variables and clinical or immunological parameters. Conclusions: The findings suggest that reduced Th17 activity and enhanced regulatory immune responses contribute to recurrence and increased lesion severity in scabies within high-transmission settings.
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