Powering next-generation precision therapeutics through integrated synthetic transcriptional systems

Mammalian synthetic biology holds great promise for treating complex diseases but faces challenges such as functional leakage and imprecise control dynamics. The advent of synthetic promoters (synPs) and transcription factors (synTFs) has expanded the genetic toolkit, and their coordinated integration enables precise, intelligent, and multidimensional regulation. Advances in promoter engineering and modular synTF design, aided by artificial intelligence, have shifted the field from empirical, trial-and-error discovery to rational, predictive design. This progress has facilitated the construction of synthetic circuits that integrate multiple endogenous and exogenous inputs through logic gates, feedback loops, and tunable systems. Such innovations support dynamic, spatiotemporally precise control, enhancing therapeutic precision and reducing off-target effects. By addressing key translational requirements, including multi-input sensing, tunable expression, and high orthogonality, integrated synP-synTF systems are advancing sophisticated mammalian therapeutics. This review summarizes progress in engineered and integrated systems, highlighting dynamic regulatory strategies and their therapeutic applications.