{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T20:01:56Z","timestamp":1791489716597,"version":"4.3.4"},"reference-count":81,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NextGenerationEU-MUR M4C2.I.1.3 PNRR","award":["PE00000007, INF-ACT"],"award-info":[{"award-number":["PE00000007, INF-ACT"]}]},{"name":"NextGenerationEU-MUR M4C2.I.1.3 PNRR","award":["(COC-1- 2023-ISS-01)\u2014CUP I83C22001810007"],"award-info":[{"award-number":["(COC-1- 2023-ISS-01)\u2014CUP I83C22001810007"]}]},{"name":"One Health Basic and Translational Research Actions addressing Unmet Needs on Emerging Infectious Diseases","award":["PE00000007, INF-ACT"],"award-info":[{"award-number":["PE00000007, INF-ACT"]}]},{"name":"One Health Basic and Translational Research Actions addressing Unmet Needs on Emerging Infectious Diseases","award":["(COC-1- 2023-ISS-01)\u2014CUP I83C22001810007"],"award-info":[{"award-number":["(COC-1- 2023-ISS-01)\u2014CUP I83C22001810007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infections (ALRIs) in young children, especially bronchiolitis, with significant global health and economic impact. Increasing evidence links early-life RSV infection to long-term respiratory complications, notably recurrent wheezing and asthma. This narrative review examines these associations, emphasizing predictive factors and emerging biomarkers for risk stratification. Early RSV infection can trigger persistent airway inflammation and immune dysregulation, increasing the likelihood of chronic respiratory outcomes. Risk factors include severity of the initial infection, age at exposure, genetic susceptibility, prematurity, air pollution, and tobacco smoke. Biomarkers such as cytokines and chemokines are showing promise in identifying children at higher risk, potentially guiding early interventions. RSV-related bronchiolitis may also induce airway remodeling and promote Th2\/Th17-skewed immune responses, mechanisms closely linked to asthma development. Advances in molecular profiling are shedding light on these pathways, suggesting novel targets for early therapeutic strategies. Furthermore, passive immunization and maternal vaccination offer promising approaches to reducing both acute and long-term RSV-related morbidity. A deeper understanding of RSV\u2019s prolonged impact is essential to develop targeted prevention, enhance risk prediction, and improve long-term respiratory health in children. Future studies should aim to validate biomarkers and refine immunoprophylactic strategies.<\/jats:p>","DOI":"10.3390\/v17081073","type":"journal-article","created":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T06:37:47Z","timestamp":1754030267000},"page":"1073","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Predictive Factors and Clinical Markers of Recurrent Wheezing and Asthma After RSV Infection"],"prefix":"10.3390","volume":"17","author":[{"given":"Luca","family":"Buttarelli","sequence":"first","affiliation":[{"name":"Pediatric Clinic, Pietro Barilla Children\u2019s Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Caselli","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Pietro Barilla Children\u2019s Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Gerevini","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Pietro Barilla Children\u2019s Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Leuratti","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, Pietro Barilla Children\u2019s Hospital, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7421-0903","authenticated-orcid":false,"given":"Antonella","family":"Gambadauro","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi\u201d, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5420-8411","authenticated-orcid":false,"given":"Sara","family":"Manti","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi\u201d, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-2837","authenticated-orcid":false,"given":"Susanna","family":"Esposito","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Human Pathology in Adult and Developmental Age \u201cGaetano Barresi\u201d, University of Messina, 98124 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1016\/S0140-6736(17)30938-8","article-title":"Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in young children in 2015: A systematic review and modelling study","volume":"390","author":"Shi","year":"2017","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1016\/S0140-6736(22)00478-0","article-title":"Global, regional, and national disease burden estimates of acute lower respiratory infections due to respiratory syncytial virus in children younger than 5 years in 2019: A systematic analysis","volume":"399","author":"Li","year":"2022","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Gil-Prieto, R., P\u00e9rez, J.J., Drago, G., Kieffer, A., Ro\u00efz, J., Kazmierska, P., Sardesai, A., de Boisvilliers, S., L\u00f3pez-Belmonte, J.L., and Beuvelet, M. 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