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.

自然杀伤细胞在排斥肿瘤和病原体感染细胞方面起着至关重要的作用。NK 细胞通过直接靶向感染细胞，在针对病毒感染的早期免疫反应中不可或缺。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。呼吸道合胞病毒是一种引起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。然而，由于免疫记忆发育受损，针对 RSV 的免疫是短暂的。NK 细胞在 RSV 感染过程中的作用仍然不明确。NK 细胞在 RSV 感染中发挥双重作用；最初，它们的作用是保护性的，因为它们利用其内在的细胞毒性，其次是有害的，由于抗体反应的抑制和促炎因子的分泌而导致肺损伤。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方面发挥着关键作用。事实上，NK 细胞具有促炎和抑制作用，而不是导致疾病严重程度的细胞毒性作用。目前正在测试治疗方案，包括基于 DNA 蛋白质的疫苗、合成肽和减毒株。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，我们重点关注 NK 细胞在免疫反应中的作用及其对 RSV 疾病免疫发病机制的影响。