Engineering smart bacteria for the next generation.

Qiao, Longliang; Wang, Zhihao; Tang, Shasha; Tian, Jinzhong; Ye, Haifeng; Cai, Fengfeng · Cell Rep Med · 2026

review · Level V

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Abstract

The rational design of smart bacteria represents a transformative advance in synthetic biology, enabling unprecedented spatiotemporal precision in microbial sensing and signal processing. By integrating sophisticated genetic circuits, these engineered systems can detect a wide range of environmental and disease-associated cues, positioning them as powerful tools for both diagnosis and therapy. Recent developments have broadened their clinical utility, including in situ therapeutic delivery and remote-controlled activation in response to chemical, physical, or pathological signals. This review summarizes recent progress in genetic circuit engineering, explores clinical applications across multiple disease contexts, and discusses key challenges and future directions for translating smart bacteria into next-generation precision medicine.

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