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, TGF.beta.1, TGF.beta.-RII, Sftpa1, Csf2, Cxcl1, Cxcl2, Cxcl5, IL-8R.beta., IL-8R.alpha., IL-6, TNF, EGF-R, Areg, PDGF.alpha., HpGF, FGF7, Kdr, flt1, Angpt1, Tek, HIF1.alpha., Hyou1, PGF, and tropoelastin.