Detection and Clinical Implications

T he first Aspen Lung Conference entitled “Symposium on Emphysema and the Chronic Bronchitis Syndrome,” was held in 1958. It’s purpose was to develop an understanding of what these terms meant and to begin to unravel the causes and factors associated with the prognosis. The original Aspen Emphysema Conferences were funded by contracts from a branch of the United States Public Health Service. The 8th Aspen Emphysema Conference was held in 1965. It focused on therapy, and chronic bronchitis and emphysema were redefined. Surgery for emphysema was briefly considered. Oxygen therapy was introduced as a possible solution for selected patients with advanced stages of COPD. Principles of home care and pulmonary rehabilitation were introduced. The next three Aspen Emphysema Conferences were on contemporary research in COPD and related disorders. Beginning with the 12th, these conferences have been supported by donations from industry and from private individuals. The 13th conference was the first to be published as a special supplement in CHEST, and this has been the tradition from that time onward. The 16th conference was on acute lung injury and ARDS. At that time, the conference’s name was changed to the Aspen Lung Conference. The most common themes of the previous conferences have been COPD, the pulmonary circulation, asthma, and ARDS. A variety of more basic topics, including the relationship between the environment and the lung and the basic science of the lung, have also been covered. The 26th conference again dealt with COPD and helped us further understand the pathophysiology, structure, and function of disorders characterized by chronic progressive airflow obstruction. It has now been 16 years since COPD was the theme, and most attendees considered this an inordinately long hiatus in view of the explosion of knowledge based upon multidisciplinary research that is gaining momentum. This year’s conference was on the “Mechanisms of COPD.” Understanding mechanisms of disease forms the foundation for new therapies. This supplement contains state-of-the-art reviews, as well as abstracts of reports that were presented after the state-of-the-art presentations or in the poster sessions. In some cases, slightly expanded mini-papers are included. A special commentary by Professor N. G. M. Orie, MD, about the Dutch hypothesis and the masterful summary by Robert Senior, MD, will be appreciated by all who read this supplement. We hope the readers share some of the thrill that we felt as we attended the 42nd Aspen Lung Conference. We thank the Francis Families Foundation for their support of the Annual Parker B. Francis Lectureship. We greatly appreciate the generous support of all the sponsors of this year’s conference, and we thank Mrs. Jeanne Cleary for her tireless work, which again made this conference a huge success.