Theranostic innovation in infectious lung diseases: integrating biotechnology and nanotechnology for precision medicine.

INTRODUCTION: Introduction: Infectious lung diseases, including pneumonia, tuberculosis (TB), COVID-19, influenza, and emerging fungal infections, are major causes of illness and death worldwide. Traditional methods have serious limitations such as diagnostic delays, antimicrobial resistance, and non-targeted therapy. Theranostics offers a transformative precision medicine paradigm for pulmonary infections. AREAS COVERED: This review looks closely at how biotechnology and nanotechnology synergistically advance theranostic strategies for infectious lung diseases. We explore biotechnological tools including CRISPR-Cas systems, non-coding RNAs (ncRNAs), and monoclonal antibodies (mAbs) for detecting specific pathogens and intervening directly. We also discuss nanotechnological platforms such as nanosensors, surface-enhanced Raman spectroscopy (SERS), and various nanocarriers (lipid nanoparticles, polymeric nanoparticles, liposomes, metallic nanoparticles, mesoporous silica nanoparticles, and biomimetic systems) for drug, gene, and vaccine delivery with better targeting, controlled release, and imaging capabilities. Integrated case studies across major diseases, including COVID-19, influenza, TB, pneumonia, COPD, and idiopathic pulmonary fibrosis, demonstrate effective theranostic applications. We also address associated challenges like safety, manufacturing, regulatory hurdles, and economic feasibility. EXPERT OPINION: The combination of biotechnology and nanotechnology represents a paradigm shift toward personalized pulmonary medicine. Future success needs to develop smart, multi-stimuli-responsive nanoplatforms, integrating artificial intelligence for predictive modeling and treatment optimization, and establishing closed-loop theranostic systems that connect real-time diagnostics with adaptive therapies. Key priorities include standardized preclinical models, clear regulations for combination products, and health economic analyses demonstrating cost-effectiveness. Interdisciplinary collaboration among material scientists, molecular biologists, clinicians, and regulatory specialists will be essential to translate these promising platforms from bench to bedside.