The effects of the DASH dietary pattern on clinical outcomes and quality of life in adults with uncontrolled asthma: Design and methods of the ALOHA Trial.

BACKGROUND: Poor diet quality is an important risk factor for increased asthma prevalence and poor asthma control. To address the question of whether adults with asthma can benefit from following a healthy diet, this trial will test the efficacy and mechanisms of action of a behavioral intervention promoting the Dietary Approaches to Stop Hypertension (DASH) dietary pattern with sodium reduction among patients with uncontrolled asthma. METHODS: In this 2-arm randomized clinical trial, 320 racially/ethnically and socioeconomically diverse adults with uncontrolled asthma on standard controller therapy will be randomized to either a control or an intervention group and assessed at baseline, 3, 6 and 12 months. Control and intervention participants will receive education on lung health, asthma, and other general health topics; additionally, the intervention group will receive DASH behavioral counseling over 12 months. The primary hypothesis is that the DASH behavioral intervention, compared with the education-only control, will lead to significantly more participants with minimum clinically important improvement (responders) in asthma-specific quality of life at 12 months. Secondary hypotheses will test the intervention effects on other asthma (e.g., asthma control, lung function) and non-asthma outcomes (e.g., quality of life). Additionally, therapeutic (e.g., short chain fatty acids, cytokines) and nutritional biomarkers (e.g., dietary inflammatory index, carotenoids) will be assessed to understand the mechanisms of the intervention effect. CONCLUSION: This trial can substantially advance asthma care by providing rigorous evidence on the benefits of a behavioral dietary intervention and mechanistic insights into the role of diet quality in asthma. CLINICALTRIALS: gov #: NCT05251402.

Dose response effect of diaspirin crosslinked hemoglobin (DCLHb) on systemic hemodynamics and regional blood circulation in rats.

Diaspirin crosslinked hemoglobin (DCLHb, Baxter Healthcare Corporation) a hemoglobin-based blood substitute has been found to increase mean arterial pressure (MAP) in a dose limiting manner. The present study was undertaken to determine dose-dependent effects of DCLHb on systemic hemodynamics and regional blood circulation. DCLHb (10% solution) in doses of 133, 400 and 1200 mg/kg i.v. was given to urethane anaesthetized rats. Normal saline (12 ml/kg) served as a control. Cardiovascular parameters were determined using a radioactive microsphere technique. DCLHb in the doses of 133, 400 and 1200 mg/kg i.v. produced a 46%, 67% and 65% increase in MAP, respectively. Total peripheral resistance (TPR) increased significantly with 133 and 400 mg/kg dose, while cardiac output increased significantly with 400 and 1200 mg/kg dose. There was no change in heart rate. A dose of 133 mg/kg of DCLHb produced a significant decrease in blood flow to the musculoskeletal system, kidney and liver. DCLHb in the dose of 400 and 1200 mg/kg significantly increased blood flow to the heart, gastrointestinal tract (GIT), mesentery & pancreas and skin. All doses of DCLHb produced a significant increase in vascular resistance to the musculoskeletal system and liver. DCLHb in the dose of 133 mg/kg increased resistance to the GIT. heart, skin and kidneys, while the dose of 400 mg/kg increased resistance to the kidneys. A dose of 1200 mg/kg decreased coronary vascular resistance. It is concluded that cardiovascular effects appear to be different with higher (1200 mg/kg) and lower (133 mg/kg) doses of DCLHb.