The role of cytokines as immunological biomarkers of disease severity during respiratory syncytial virus (RSV) infection in children.

Respiratory syncytial virus (RSV) remains a leading viral cause of lower respiratory tract infections in infants and young children. The RSV infection of the respiratory epithelium elicits a complex immune response characterized by the production of a broad spectrum of pro- and anti-inflammatory cytokines. Emerging evidence indicates that the magnitude and temporal dynamics of these cytokine responses are closely associated with disease severity and clinical outcomes. Recent advances in immunopathological profiling have highlighted the potential of cytokine signatures as biomarkers of severe RSV disease, offering opportunities for early risk stratification and targeted clinical intervention. Although therapeutic options remain largely supportive, substantial progress in preventive strategies, including the introduction of monoclonal antibodies and newly licensed vaccines, represents an important step toward reducing the global burden of RSV disease. Despite these advances, reliable immunological biomarkers for clinical decision-making remain an unmet need. In this review, we synthesize current evidence on cytokine responses associated with severe RSV infection in children, with particular emphasis on their clinical utility as biomarkers of disease severity.