Comment

The extracellular matrix (ECM) is a key component of the stem-cell niche, and undergoes profound changes during ageing, affecting tissue mechanics and structure. Here, we argue that ECM alterations can be leveraged to engineer biomaterials to investigate age-mediated tissue dysfunction, and to design therapeutic strategies for age-related diseases.

Pancreatic islet transplantation stands to enable patients with type 1 diabetes to become insulin-independent. However, the number of islets required to achieve insulin independence is not yet well-defined and depends on the transplantation approach. Here, we contextualize a ‘rule of thumb’ estimate of the islet quantities required for transplantation, and discuss the estimate’s practical implications.

Ageing and cancer development are tightly interwoven processes. Here, we discuss preventing cancer by reducing or reverting epigenetic age. We provide an outline for how this can be achieved by targeting the mechanisms that drive DNA methylation clocks.

Bidirectional neuromorphic brain interfaces, based on interconnecting brain networks with artificial spiking neural networks, aim to optimize neural prostheses to help people with paralysis to regain autonomy. Their emergence questions the concept of human subjectivation, the continuous process by which we become and remain the subject of our life.

Micro- and nanorobots hold great potential to overcome brain barriers for the treatment of brain diseases. They can be delivered to the brain by local injection, intranasal application, or systemic administration. Combining active propulsion with biological and chemical approaches or external physical stimuli can improve brain targeting.

In a multilinguistic science learning environment, science educators should rely on effective pedagogies to teach students with different mother languages and socio-cultural backgrounds. Institutes that invest in bias awareness training for students and instructors will help to create an inclusive learning environment. This can be achieved by opening science classrooms to social science researchers who can inform the development of a signature pedagogy of science.

The clinical translation of biomedical research requires a culture of solutions as a second critical pillar next to discovery. Engineers use biomedical and other knowledge, with a solution-oriented mind-set, to generate tools and concepts that catalyse the transformation of knowledge into medical solutions. In this light, bioengineering becomes the driving force of accelerating clinical translation and introducing new concepts in validation, prevention, diagnostics and precision therapy.

Cancer nanotherapy suffers from low-yield delivery that is imposed by tumour pathophysiological barriers. Top-down drug delivery strategies, including exosomes and cell membrane-coated particles, can improve safety and efficacy owing to the innate biointerfacial properties of these platforms. Here, we discuss the technological challenges that need to be overcome for their clinical implementation.

CRISPR-based assays can be adopted as ultrasensitive molecular diagnostics in resource-limited settings, but point-of-care applications must address additional requirements. Here, we discuss the major obstacles for developing these assays and offer insights into how to surmount them.

Delivery of vaccines by nasal sprays may enable more robust, protective mucosal immune responses against infectious diseases, such as COVID-19, compared with intramuscular injection. In this Comment, we highlight how biomaterials can be designed to allow intranasal and inhaled vaccination.

Biomarkers in breath can be related to certain diseases, which makes breath-based analysis a powerful diagnostic tool. Here we highlight milestones and remaining challenges for the broad clinical implementation of wearables for breath analysis.

Metabolomics is on the precipice of transforming from a research tool into a powerful clinical platform to improve precision medicine. However, metabolomics methods need to be validated in clinical research to enable rapid translation of research results into clinical tests.

Engineers need to meaningfully engage in global health by developing solutions that work in the low-resource environments that are a reality for many health-care professionals and patients around the world. Engineering World Health, founded in 2001, aims to inspire, educate and empower the biomedical engineering community to improve health-care delivery around the world.