Genetically programmable wearable devices for precision physiological and molecular monitoring.

Wearable devices have emerged as powerful tools for continuous, real-time health monitoring, enabling the detection of biochemical markers in sweat, tears, saliva, and interstitial fluid. However, existing wearable materials are hindered by limited chemical functionality, static sensing capabilities, and insufficient adaptability to dynamic physiological conditions, which restrict their current impact in precision medicine. Recent advancements have focused on integrating genetic engineering and synthetic biology into wearable platforms, resulting in genetically programmable biointerfaces that enhance specificity, responsiveness, and functional versatility in clinical and personalized healthcare settings. Current applications of these bioengineered devices include real-time monitoring of pathogens, hormones, therapeutic drug levels, and physiological behaviors, offering superior precision and adaptability compared to traditional wearable technologies. This review highlights two key engineering approaches driving this field: genetically modified living cells and cell-free synthetic biology systems. While promising, several challenges still limit broader clinical adoption, including biosafety concerns, the instability of biological components, and translational hurdles. Addressing these challenges requires progress in biocompatibility, controlled gene expression, and durable wearable materials. Looking ahead, future research should aim to integrate these biointerfaces with implantable and smart therapeutic systems, develop autonomous biosensors with self-regulatory functions, and further expand their use in personalized medicine and real-time disease management. By bridging genetic programming with wearable diagnostics, these innovations are laying the groundwork for next-generation biohybrid systems designed to advance precision healthcare.