Current Progress and Future Outlook for Synthetic Gene Circuits in Cardiovascular Therapy.

Despite decades of therapeutic advances, cardiovascular diseases remain the leading cause of global mortality, underscoring the need for strategies that move beyond untargeted systemic pharmacotherapy. Synthetic biology introduces a programmable therapeutic paradigm in which engineered gene circuits can sense, compute, and respond to pathological signals with spatiotemporal precision. This review examines the current progress of synthetic gene circuits for cardiovascular therapy, organized across three domains of clinical relevance. The first domain comprises circuits engineered for direct cardiac applications, from inducible switches to classifier systems. This discussion is further expanded by exploring circuits that indirectly target cardiovascular disease; these circuits address upstream risk factors such as cholesterol dysregulation and chronic inflammation. Looking ahead, the focus shifts to orthogonal architectures pioneered in other therapeutic contexts that hold promise for future cardiac applications. This review further discusses the emerging role of computational tools, including gene regulatory network inference and foundation models, in accelerating target discovery. Finally, a modified Design-Build-Test-Learn framework is proposed to overcome translational bottlenecks, thus paving the way for next-generation cardiac therapeutics.