Lungs’main function is that of transporting oxygen from the atmosphere into the blood and taking carbon dioxide out of the blood and into the atmosphere. This process entails a whole set of events during ventilation, but it works only if oxygen molecules flow very quickly from the alveolus’ center to the respiratory membrane. Alveolar size is critical to sustaining a regular gas exchange through the respiratory membrane, in particular when the subject’s oxygen consumption increases when passing from a resting state to a state of stress. Emphysema progressively destroys normal alveolar size and anatomy. Right now there is no possibility to reverse the damage caused and transplant appears to be the only opportunity available to treat emphysema. Pulmonary emphysema onset and development are due to several causes and the knowledge of genetic determinants and pathological phenotype are likely to become the major challenge in the future of respiratory medicine. The epidemiology of emphysema cannot be easily distinguished from that of chronic obstructive pulmonary disease (COPD), as pulmonary emphysema is part of COPD. It is difficult to evaluate emphysema treatment needs in a population, except for the lack of alfa1antitrypsin. Knowing population treatment needs and epidemiology is the basic condition allowing us to control risk factors and disease progression in the world. We can actually propose some methods to treat critical advanced emphysema, but the anatomopathological basis of pulmonary tissue destruction and remodeling, ventilatory function changes and alveolar wall disease will be at the basis of any future pulmonary emphysema therapies. The meeting “Emphysema today: news and old problems”, to be held in Bologna (Italy), on 8th-10 th September 2011 will try to assess our knowledge in the field of chronic respiratory diseases.
Prof. Franco Falcone President of the Meeting