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Twenty ILDs patients were included in the study, comprising those with idiopathic pulmonary fibrosis (IPF) (n:8), autoimmune\u2010related ILDs (auto\u2010ILD) (n:4), and orphan diseases (O\u2010ILD) (n:8), alongside five control subjects. Flow cytometry was employed to evaluate the Th to cytotoxic T\u00a0cell (CTL) ratio in BAL fluid, while cytopathological examination assessed macrophages, lymphocytes, and neutrophils. Quantitative real\u2010time polymerase chain reaction was utilized to investigate the expressions in Th1, Th2, Th17, and regulatory T (Treg) cells. Results revealed elevated Th cell to CTL ratios across all patient groups compared to controls. Furthermore, upregulation of Th1, Th2, Th17, and T\u2010cell factors was observed in all patient groups compared to controls. Interestingly, upregulation of <jats:italic>CD28<\/jats:italic> and downregulation of <jats:italic>CTLA\u20104<\/jats:italic> and <jats:italic>PD\u20101<\/jats:italic> gene expression were consistent across all ILDs groups, highlighting potential immune dysregulation. This study provides a comprehensive exploration of molecular immunological mechanisms in ILDs patients, underscoring the dominance of Th2 and Th17 responses and revealing novel findings regarding the dysregulation of <jats:italic>CD28<\/jats:italic>, <jats:italic>CTLA\u20104<\/jats:italic>, and <jats:italic>PD\u20101<\/jats:italic> expressions in ILDs for the first time.<\/jats:p>","DOI":"10.1111\/apm.13445","type":"journal-article","created":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T08:49:56Z","timestamp":1718095796000},"page":"663-671","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Changes in T\u2010cell subsets occur in interstitial lung disease and may contribute to pathology via complicated immune cascade"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3201-8945","authenticated-orcid":false,"given":"Mehmet 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