Emphysema and COPD are diagnosed, and the efficacy of therapeutic drug candidates for the treatment of emphysema and / or COPD is evaluated, by determining biomarkers selected from the group SpB, desmosine, VEGF, IGFBP2, MMP12, TIMP1, MMP9, Crabp2, Rbp1, Cyp26a1, Tgm2, Timp3, Adam17, Serpina1, Slpi, Col1a1, Eln, TGFβ1, TGFβ-RII, Sftpa1, Csf2, Cxcl1, Cxcl2, Cxcl5, IL-8Rβ, IL-8Rα, IL-6, TNF, EGF-R, Areg, PDGFα, HpGF, FGF7, Kdr, flt1, Angpt1, Tek, HIF1α, Hyou1, PGF, and tropoelastin.