The transformative power of CRISPR/Cas systems has extended far beyond genome editing, ushering in a new era of biosensing with unprecedented programmability, sensitivity, and speed. This plenary talk will trace the journey of CRISPR/Cas-based biosensors from fundamental laboratory breakthroughs toward real-world clinical and point-of-care applications. Drawing on over a decade of research bridging academia and industry, this talk will present our team's work on developing integrated CRISPR/Cas biosensing platforms capable of quantifying diverse markers, including nucleic acids, small molecules, and cytokines, across a spectrum of settings, from portable point-of-care testing to implantable devices for real-time in vivo monitoring. Key innovations include the engineering of Cas effectors into highly specific and sensitive signal transducers, as well as the integration of microfluidics and portable devices for multiplex detection towards biomarker discovery in chronic diseases. This talk will also discuss the critical transition from benchtop validation to commercial translation, highlighting lessons learned from industry collaborations and startup ventures. Finally, a forward-looking perspective on the remaining challenges, such as multiplexing, reagent stability, and regulatory pathways, will be presented alongside emerging opportunities for CRISPR/Cas biosensors to democratize diagnostics and enable precision medicine globally.

Continuous molecular monitoring could improve care because most clinical decisions rely on lab tests, yet outside glucose and blood oxygen, monitoring still depends on infrequent blood or urine samples that provide only isolated time points. This is especially limiting for drugs like vancomycin, which has a narrow therapeutic window and large patient-to-patient variability. To address this, we are developing wearable patches with electrochemical aptamer-based (EAB) sensors on small solid needles for continuous, real-time vancomycin measurement. These sensors use a target-binding aptamer attached to an electrode and tagged with a redox reporter such as methylene blue; target binding changes aptamer conformation, generating an electrochemical signal. In a pilot clinical trial in healthy volunteers, fully self-contained EAB patches continuously measured vancomycin in dermal interstitial fluid every 5 minutes over 24 hours. Signals were consistent across patch locations and participants, and pharmacokinetic modeling revealed drug distribution and clearance dynamics missed by standard infrequent sampling.