Engineering commensal bacteria for prophylaxis against infection

Infectious diseases are the leading causes of death worldwide. The development of efficient and low cost prophylactics to prevent pathogenic infection is given high priority in the twenty-first century. Commensal bacteria are largely seen as harmless and can survive symbiotically (in many cases) in niches throughout the human body. Advances in genetic engineering and understanding of pathogenesis have revealed many potential strategies to develop engineered bacteria for prophylaxis purposes: including live vaccines and anti-infective agents. In this review, we discuss recent advances and potentialities of prophylaxis with engineered bacteria.

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► Advantages of using commensal bacteria as delivery systems.
► Different strategies were used to engineer commensal bacteria to target bacterial or viral infection through inhibiting virulence expression, producing bacteriocins, neutralizing toxins, preventing adhesion, blocking fusion sites, and enhancing the immune response of host cells.
► Current challenges and future perspectives were also discussed.