title: Differential Expression of Circulating Monocyte MicroRNAs for Osteoclastogenesis and Inflammation in the Causation of Diabetic Charcot Neuroarthropathy: A Case-Control study
design: MiRNAs related to bone metabolism and inflammation would be differentially expressed in patients with active CN of foot compared to people with diabetes but without CN and patients with leprosy with distal sensory neuropathy. Also, alterations in miRNA expression after treatment of active CN of foot may have the potential to aid in defining remission of active CN other than clinical criteria. Differential expression profiling of miRNA as compared to similar controls will elucidate the pathophysiology for the causation of CN and the further change in expression on treatment will aid in identifying molecular targets for therapeutic intervention. Genetic signature involved in bone metabolism and inflammation is not studied for CN. The project entails the miRNA profile of CN for the first time compared to cohort with diabetic neuropathy or leprosy. The differentially expressed miRNA that are related to bone metabolism or inflammation in CN as compared to people with diabetic neuropathy or leprosy will elucidate the causative pathophysiology of CN. The correlation between the change in MiRNA and clinical remission will help in identifying the patients with likelihood of clinical remission. The differentially expressed MiRNA and their downstream pathway can identify targets for therapeutic intervention in CN. The expected outcome could be Diagnostic or Prognostic-Biomarker