Review Articles

Human organoids offer experimental models that closely replicate human biology, enabling the investigation of infectious disease mechanisms across diverse organ systems, especially for viral pathogens. This Review highlights their applications in studying host–virus interactions, supporting therapeutic and vaccine development, and improving pandemic preparedness, while emphasizing the need for greater complexity, standardization and scalability.

Digital twins of the human circulatory system aim to integrate real-time physiological data with computational models to understand, monitor and treat cardiovascular and haematological diseases. This Review outlines the components, clinical applications and emerging technologies enabling such digital twins, highlighting the remaining challenges to achieving real-time, predictive and closed-loop clinical use.

Chimeric antigen receptor (CAR)-T cell therapy has transformed haematological cancer treatment but remains limited by intrinsic T cell constraints. This Review discusses emerging CAR-engineered immune cells beyond conventional T cells, highlighting how their distinct biological features, tailored manufacturing strategies, and specialized CAR designs address key challenges and expand the therapeutic potential of CAR-based immunotherapy.

Digital biomarkers derived from smartphones, wearables and ambient sensors enable continuous, real-world monitoring of neurological disease. This Review proposes a standardized framework for classifying digital biomarkers across neurodegenerative diseases, structured around what is measured, how it is sensed and why it is applied, highlighting opportunities for improved monitoring, early detection and personalized care.

Cell sheet engineering offers a scaffold-free approach to tissue reconstruction. This Review outlines fabrication methods, key mechanical design strategies and innovations aimed at enabling the use of cell sheets in mechanically demanding tissues.

Gait impairments such as freezing, weakness and imbalance remain resistant to standard therapies across neurological disorders. This Review examines advances in neuromodulation, from refining deep brain stimulation to integrating spinal and distributed strategies. It discusses adaptive neurotechnologies, mechanistic insights and a framework for tailoring spatiotemporally precise interventions to restore gait control.

mRNA vaccines combine rapid design, scalable manufacturing and strong safety profiles with applications across infectious diseases, cancer and autoimmune disorders. However, global access to mRNA vaccines remains limited. This Review explores how achieving equitable access depends on overcoming technical, logistical, economic and regulatory barriers through innovations in thermostability, delivery systems, alternative RNA platforms, artificial intelligence-driven design and optimization, and coordinated policy strategies.

Designing therapeutics for children requires careful consideration of age-dependent anatomy, physiology and immunology. This Review discusses the engineering and optimization of drug delivery systems for paediatric microenvironments to prevent, treat and cure childhood diseases.

Biohybrid microrobots combine biological and synthetic components to navigate complex in vivo environments for applications such as drug delivery, microsurgery and diagnostics. This Review introduces a biophysics-informed design framework for biohybrid microrobots that translates natural adaptive strategies into engineering solutions across deformation, actuation, navigation and programming.

Gasotransmitters, including nitric oxide, hydrogen sulfide and carbon monoxide, are involved in maintaining homeostasis and play multifaceted roles in pathological pathways. This Review discusses imaging techniques that permit real-time in vivo visualization of gasotransmitter dynamics and explores the clinical potential of gasotransmitter imaging.

Xenotransplantation aims to address the shortage of human organs by using organs from species other than human; in particular, porcine organs share similarities with human organs in key aspects. This Review highlights major challenges in xenotransplantation, such as immune rejection and disease transmission, and explores solutions, such as gene editing, immunomodulation, and robust safety and ethical frameworks to enable future success.

Synthetic biology might enable the bottom-up construction of synthetic genomes, offering a foundation for building synthetic cells. This Review discusses strategies for rational genome design, genome-scale organization, and integration of experimental and computational methods to realize a fully synthetic cell.

Extracellular vesicles (EVs) are emerging as biocompatible carriers for targeted drug delivery, yet challenges in yield, cargo loading and biodistribution persist. In this Review, key trends from over a decade of research are analysed, comparing EVs with lipid-based systems and outlining strategies for improving therapeutic translation and reporting standards.

Lipid nanoparticles can serve as carriers for RNA therapies, enabling efficient encapsulation, cellular uptake and controlled protein expression. This Review explores their design principles, key components, physicochemical properties and therapeutic potential, highlighting how formulation parameters influence delivery performance.

Immune interactions are complex, dynamic and difficult to capture using static imaging modalities on in vitro or ex vivo tissue cultures. In this Review, the authors discuss techniques for in vivo imaging of the immune system including one-photon near-infrared II fluorescence and two-photon and multiphoton microscopy for longitudinal tracking of immune cells, as well as a translational path that integrates near-infrared II, positron-emission tomography or MRI and artificial intelligence-enabled analysis towards quantitative, clinically compatible, multimodal immuno-imaging.

mRNA technologies offer potential solutions for HIV-1 vaccine development by enabling rapid, safe and modular antigen design that can initiate rare antibody lineages required for broad protection. In this Review, we discuss preclinical and early clinical evidence, outline remaining challenges — particularly breadth and durability — and discuss delivery and manufacturing advances that may help translate these approaches into effective preventive and therapeutic strategies.

Organoids offer physiologically relevant 3D models, yet translating them into clinical and industrial use requires robust analytical platforms. In this Review, key strategies for characterizing electrophysiological, biophysical and optical properties are discussed, alongside the integration of omics and computational technologies to decode organoid function and behaviour.

Delivering drugs directly to the lungs enables targeted treatment and long-term drug retention, while minimizing systemic side effects. This Review explores the design of microrobotic platforms engineered for pulmonary drug delivery.

Mechanical forces are crucial regulators of biological functions in health and disease, offering measurable biomarkers and therapeutic targets. This Review introduces the principles of mechanomedicine and highlights its translational potential across scales, from tissue diagnostics to molecular mechanotherapeutics.

Continuous neuromonitoring is vital for guiding neurocritical care, yet artefacts frequently obscure cerebral physiological signals and hinder clinical decisions. In this Review, sources of artefacts and their clinical impact are examined, alongside emerging strategies — both knowledge-based and data-driven — for artefact mitigation, sensor design and artificial intelligence-enabled real-time monitoring in precision neurocare.