A recent study has shown that patients with exfoliation syndrome (XFS) have a higher rate of chronic obstructive pulmonary disease (COPD), especially if exposed to tobacco; however, COPD patients do not have a higher rate of increased XFS risk. Researchers also found that XFS patients with COPD had a survival advantage over individuals only diagnosed with COPD.

Using Utah Population Database–linked medical records, the study evaluated 2,943 patients with XFS, 20,589 patients with COPD and 162 patients with both disorders seen between 1996 and 2015. In XFS patients, risk of a COPD diagnosis was 1.4x increased compared with controls. The subset of tobacco users had a 2.17x increased risk.

Researchers hypothesize that tobacco use and the genetic predisposition to lysyl oxidase–like 1-related XFS could alter the elastin repair processes, increasing the COPD risk in tobacco users. They believe that the exploration of XFS’s role with disorders of elastin and extracellular matrix metabolism has just begun. Therefore, they deem it important to have a broader appreciation of XFS as a systemic condition that may require increasing medical attention and to also be open to target therapy. Although XFS morbidity and mortality may not be increased, longevity may be a characteristic of the disorder, even when COPD undermines the survival of those same patients.