Engineering cells for therapy and diagnosis

Abstract

Personalized therapy offers tailored treatment solutions for individual patients to minimize treatment-associated side effects and improve prognosis. In particular, endogenous cells, exogenous cells and bacterial cells can be designed to enable precise disease diagnosis and personalized therapy, capitalizing on inherent and engineered functions and properties of different cell types. In this Review, we discuss the engineering of both mammalian and bacterial cells for disease diagnosis and therapy, including genetic engineering, bioconjugation, cell fusion, cell membrane wrapping, cell backpacks, cell surface coating and intracellular drug loading approaches, outlining advantages and limitations of each engineering strategy for distinct therapeutic applications. We also highlight how mammalian and bacterial cells can be designed as biosensors and imaging tools for disease diagnosis, and survey promising preclinical and clinical investigations of engineered cell therapies, emphasizing future milestones for clinical translation. Finally, we discuss strategies to increase the safety and efficacy of engineered cell therapies, improve their functionalities and promote their large-scale manufacturing. Cells can be engineered to modify their function and behaviour for therapeutic and diagnostic applications. This Review discusses biological, genetic and materials-based engineering approaches for both mammalian and bacterial cells, outlining key design strategies and applications of engineered cell products.