Engineered microbial sensors: providing a new paradigm for disease detection

Microorganisms can be programmed into engineered microbial sensors (EMSs) capable of responding to disease biomarkers. Compared to traditional diagnostics, EMSs exhibit superior advantages in cost-effectiveness, environmental adaptability, and non-invasive, in situ diagnostics. These advantages have been further bolstered by recent advances in synthetic biology, which have improved the reliability, accuracy, and safety of EMSs in disease detection, particularly in vivo. In this review, we elucidate the fundamental design principles of EMSs and summarize their research progress across diverse diagnostic scenarios. Furthermore, we evaluate recent advances in EMSs encapsulation strategies, including micro- and macro-encapsulation, and their potential for translation into practical applications. Finally, we outline future perspectives and analyze key challenges in the medical applications of EMSs, including biosafety concerns, signal stability issues, and the absence of standardized clinical evaluation protocols.