Lifespan reduction due to neoplasia is nullified by pseudoexfoliation syndrome

Jon Klokk Slettedal,Leiv Sandvik,Amund Ringvold

doi:10.1016/j.heliyon.2018.e00832

Jon Klokk Slettedal, Leiv Sandvik + Show 1 more

Open Access

https://doi.org/10.1016/j.heliyon.2018.e00832

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Journal: Heliyon	Publication Date: Oct 1, 2018
Citations: 2	License type: cc-by

Affiliation: Oslo University Hospital, University of Oslo

Abstract

BackgroundPseudoexfoliation syndrome (PES) is a common eye condition, indicating a risk of various eye diseases. Whether or not PES has extra-ocular physiological or even pathophysiological implications has been a matter of controversy for years. MethodsIn total 1888 persons were examined for PES in 1985–86. Of these, 1864 (98·7%) had died and were therefore available for analysis by 01.01.2016. Age and cause(s) of death were recorded. 9 diagnostic groups (cardiovascular disease, cerebrovascular disease, neoplasms, systemic hypertension, diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), Parkinson's disease, aortic aneurysm (AA), and amyloidosis) based on ICD-coding were analyzed for both a possible association between PES and lifespan, as well as PES and specific systemic diseases. FindingsIn the cardiovascular group, PES was not associated with an alteration in longevity. The subgroups acute myocardial infarction and other cardiovascular diseases revealed significantly reduced and increased lifespan, respectively, compared to the rest of the population. These deviations were independent of PES. The impact of PES on the neoplasm group showed that PES-positive persons lived 1·81 years (p < 0·001) longer than PES-negative persons. No significant differences in the PES prevalence were found in any of the cause of death diagnostic groups. InterpretationsThe present study suggests that lifespan reduction due to neoplasia is nullified by PES, and that this phenomenon is not restricted to one specific neoplasm type. Thus, the paradoxical conclusion emerges that PES provides a lifespan benefit to the patient with a neoplasm. For the remaining diagnostic groups, PES was neither associated with an altered lifespan, nor with any cause of death diagnoses.

Highlights

Ocular Pseudoexfoliation syndrome (PES) was first described in 1917 [1]
Interpretations: The present study suggests that lifespan reduction due to neoplasia is nullified by PES, and that this phenomenon is not restricted to one specific neoplasm type
The paradoxical conclusion emerges that PES provides a lifespan benefit to the patient with a neoplasm

Summary

Introduction

Ocular PES was first described in 1917 [1]. The most striking eye changes are small grey deposits on the anterior lens surface and along the pupillary border. The aberrant material showed similarities with elastic fibrils both biochemically [6], and in electron microscopic sections [7] These observations have been confirmed [8], and extended through the demonstrated association between the lysyl oxidase-like 1 (LOXL1) gene and PES [9], and that LOXL1 catalyzes the deamination of lysyl, which causes polymerization of tropoelastin to elastin [10]. The subgroups acute myocardial infarction and other cardiovascular diseases revealed significantly reduced and increased lifespan, respectively, compared to the rest of the population.

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