Vitamin D Supplementation in RNA-seq Profiles of Single-core Prostate Samples, Among Veterans
Condition: Prostate Cancer; Vitamin D Deficiency; Stress Reaction
MeSH terms: Vitamin D Deficiency; Fractures, Stress
Study type: Interventional
Phase: Phase 2

Summary: 
      Veterans between the ages of 50-75, who are having a prostate biopsy, will be recruited for
      their permission to collect an extra biopsy core for RNA-sequencing. If the participants'
      treatment decision is Active Surveillance, they will be enrolled into the intervention phase
      of the study. They will receive supplementation with Vitamin D3 (4,000 IU) daily with repeat
      (surveillance) prostate biopsy one year later. At that time an extra prostate sample core
      will be collected for RNA-sequencing to determine changes over time. Measurements for
      allostatic load (body stress/inflammatory markers) will also be collected at the time of
      enrollment and at the repeat prostate biopsy visit.
    

Detailed description: 
      This is an open-label pilot study. The goal is to investigate the transcription and
      biological pathways in prostate cancer that are especially relevant to prostate cancer
      disparities between African American and Caucasian men. Also, to determine any significant
      differences in the molecular signature that exist in African American and Caucasian men in
      relation to their Vitamin D levels.

      Recruitment will be at the Urology Clinic at the Ralph H. Johnson VA Medical Center in
      Charleston, SC. Men who are scheduled for a Standard of Care prostate biopsy will be
      consented for their permission to collect an extra prostate tissue core for RNA-sequencing.

      After the pathology report is discussed by their Urologist, and the treatment decision is
      Active Surveillance, the participant is enrolled into the Intervention Phase. At that time,
      baseline allostatic load measurements (Blood pressure, pulse, waist/hip ratio, height, and
      weight for BMI) and bloodwork: (lipid panel, HgbA1c, albumin and creatinine, IL-6, CRP, and
      DHEA-s (inflammatory markers) plus a Vitamin D level, will be collected. Vitamin D3 soft gels
      (4,000 IU) daily (six months' supply) will be dispensed. A Social Determinants survey will
      also be dispensed for subject completion.

      At the Urology Standard of Care six-month follow-up appointment, the vitamin D serum level
      will be collected and the next six months' supply of vitamin D3 will be dispensed.

      At the Urology Standard of Care follow-up (repeat at 1 year) surveillance prostate biopsy, an
      extra prostate tissue core will be collected for RNA-sequencing. The allostatic load
      measurements and bloodwork will also be obtained.
    

Intervention name(s): cholecalciferol; Standard of Care Prostate Biopsy - collection of 13th core for RNA-seq; Standard of Care Prostate Biopsies at baseline and after one year vitamin D3 supplementation; Allostatic Load Measurements at baseline and after one year vitamin D3 supplementation
Intervention type(s): Drug; Procedure; Procedure; Diagnostic Test
Intervention description(s): Enrolled subjects will supplement with vitamin D3 at 4,000 IU daily for one year; RNA-seq analysis will be used to (a) identify changes in transcriptional profiles and biological pathways in the prostate between African American and Caucasian men and (b) compare Allostatic Load results to determine stress response and (c) identify changes in the molecular signature in relation to vitamin D levels; Pathology results of the prostate biopsies will be analyzed for changes in the (a) Gleason Score (b) the number of positive cores (0 to 12) and (c) the highest percentage of positive core involvement (0 to 100%).; Allostatic Load measurements to determine body stress compared at baseline and after one year of vitamin D3 supplementation. Also compared with RNA-seq results to determine stress response.
Other intervention name(s): vitamin D3; Bloodwork for HgbA1c, lipid profile, creatinine, albumin and vitamin D levels.; Body measurements: Ht. Wt, BMI, waist and hip measurements for waist/hip ratio.; Measurements of systolic and diastolic blood pressure and heart rate
Intervention MeSH terms: Vitamin D; Ergocalciferols; Cholecalciferol; Vitamins
Intervention model: Single Group Assignment
Intervention model description: Single, open-label group
Masking: None (Open Label)
Primary purpose: Basic Science