Inducible costimulator (ICOS), also called AILIM (Activation-Inducible Lymphocyte Immunomediatory Molecule) is a cell-surface receptor and belongs to the CD28 family of immune costimulatory receptors consisting of CD28, CTLA-4, and PD-1. The interaction of B7-H2/ICOS plays a critical role in Th cell differentiation, T/B cell interactions which are essential for the germinal center formation, and humoral immune responses, and as well as the production of cytokine IL-4. Also, ICOS is more potent in the induction of IL-10 production, a cytokine important for the suppressive function of T regulatory cells. The B7-1/B7-2–CD28/CTLA-4 and ICOS-B7RP-1 pathway provide key second signals that can regulate the activation, inhibition, and fine-tuning of T-lymphocyte responses. ICOS stimulates both Th1 and Th2 cytokine production but may have a preferential role in Th2 cell development. Moreover, The B7-1/B7-2-CD28/CTLA-4 and ICOS-B7RP-1 pathway has been suggested as being involved in the development of airway inflammation and airway hyperresponsiveness.