Molecular point-of-care: technological evolution, clinical applications, and future perspectives

The landscape of clinical diagnostics is undergoing a fundamental shift from centralized laboratories toward decentralized point-of-care testing (POCT) models. Conventional molecular diagnostics often suffer from prolonged turnaround times, high operational costs, and a strict reliance on sophisticated infrastructure. To overcome these limitations, modern POCT platforms have deeply integrated advanced molecular techniques. These include diverse isothermal nucleic acid amplification methods (such as LAMP, RPA, and RCA) and highly specific CRISPR/Cas recognition systems. Furthermore, coupling these biochemical reactions with microfluidic chips and smartphone-based digital platforms has enabled fully automated, "sample-in, answer-out" diagnostic capabilities. This review systematically summarizes the technological evolution of these molecular POCT platforms. It highlights their transformative clinical applications across diverse fields, including infectious disease containment, early oncology screening, cardiovascular emergency triage, and metabolic disease management. Despite remarkable progress, several critical bottlenecks still prevent the widespread clinical translation of molecular POCT. These challenges include cross-interference in multiplexed detection, enzyme stability outside strict cold chains, high costs of core components, and the lack of tailored regulatory frameworks. Addressing these barriers via synthetic biology, robust system integration, and artificial intelligence is critical to advancing the core vision of delivering rapid, accessible, and precise healthcare solutions in resource-limited settings.