Natural killer cells play a vital role in the rejection of tumors and pathogen-infected cells. NK cells are indispensable in the early immune response against viral infections by directly targeting infected cells. Furthermore, NK cells influence adaptive immunity by driving virus-specific T-cell responses. Respiratory syncytial virus, a highly contagious virus that causes bronchiolitis, is the main reason for mortality in infants and elderly patients. RSV infection triggers both innate and adaptive immune responses. However, immunity against RSV is ephemeral due to the impaired development of immunological memory. The role of NK cells during RSV infection remains ambiguous. NK cells play a dual role in RSV infection; initially, their role is a protective one as they utilize their intrinsic cytotoxicity, followed by a detrimental one that induces lung injury due to the inhibition of antibody responses and the secretion of pro-inflammatory factors. Noteworthy, IFN-γ released from NK cells play a critical role in promoting a shift to adaptive responses and inhibiting antibody responses in neonates. Indeed, NK cells have a pro-inflammatory and inhibitory role rather than a cytotoxic one that contributes to the severity of the disease. Therapeutic options, including DNA-protein-based vaccines, synthetic peptides, and attenuated strains, are presently under tests. However, there is a need for effective strategies to augment NK cell activity and circumvent the pro-inflammatory activity to benefit the host. In this review, we focused on the role played by NK cells in the immune response and its outcome on the immunopathogenesis of RSV disease.

天然杀伤细胞在肿瘤和病原体感染细胞的排斥中起着至关重要的作用。通过直接靶向感染的细胞，NK细胞在针对病毒感染的早期免疫应答中必不可少。此外，NK细胞通过驱动病毒特异性T细胞反应来影响适应性免疫。呼吸道合胞病毒是引起毛细支气管炎的高度传染性病毒，是婴儿和老年患者死亡的主要原因。RSV感染会触发先天性和适应性免疫反应。但是，由于免疫记忆发育受损，因此针对RSV的免疫性是短暂的。NK细胞在RSV感染过程中的作用仍然不明确。NK细胞在RSV感染中起双重作用。最初，它们的作用是保护性的，因为它们利用了其固有的细胞毒性，其次是有害的，由于抑制抗体反应和促炎因子的分泌而诱发肺损伤。值得注意的是，从NK细胞释放的IFN-γ在促进新生儿向适应性反应的转变和抑制抗体反应中起关键作用。实际上，NK细胞具有促炎和抑制作用，而不是导致疾病严重程度的具有细胞毒性的细胞。目前正在测试包括DNA蛋白质疫苗，合成肽和减毒株在内的治疗选择。然而，需要有效的策略来增强NK细胞活性并规避促炎活性以使宿主受益。在这篇综述中，我们集中于NK细胞在免疫应答中的作用及其在RSV疾病免疫发病机理中的作用。