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Background  Asbestosis and silicosis are characterized by diffuse or nodular interstitial lung fibrosis resulting from exposure to asbestos or silica dust, respectively. This study was designed to detect programmed cell death protein (PD-1)/programmed death ligands (PD-Ls) expression in patients with asbestosis and silicosis and to explore the possible clinical significance of PD-1/PD-Ls expression in patients with the two diseases.    Methods  Thirty patients with asbestosis, 23 patients with silicosis and 25 healthy controls were consecutively recruited and provided informed consent to participate in the study. Clinical data were collected from patients’ clinical charts. PD-1/PD-Ls expression in peripheral blood (PB) was detected using flow cytometry.    Results  PD-1 was expressed at significantly lower levels on CD4 +  or CD8 +  peripheral T cells from patients with asbestosis and silicosis than on cells from healthy controls. Similarly, significantly lower PD-L1 and PD-L2 expression was detected on CD14 +  monocytes from patients with asbestosis and silicosis than on cells from healthy controls. In addition, no significant differences in PD-1, PD-L1 and PD-L2 expression were observed between the asbestosis and silicosis groups. Moreover, the proportions of PD-1 +  CD4 +  T cells and PD-1 +  CD8 +  T cells in patients with asbestosis were positively correlated with the percentage of forced vital capacity predicted.    Conclusions  Decreased PD-1 expression on CD4 +  T or CD8 +  T cells in PB was positively correlated with the asbestosis severity, implying that pulmonary fibrosis development in patients with asbestosis was positively correlated with the downregulation of the PD-1/PD-Ls pathway.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12890-021-01531-5.

Downregulation of the PD-1/PD-Ls pathway in peripheral cells correlates with asbestosis severity