Bioelectrochemical Systems at the Crossroads of Healthcare, Biosensing, and Bioremediation

Bioelectrochemical systems (BES) represent a rapidly evolving class of hybrid technologies that merge microbiology, electrochemistry, and materials science to deliver sustainable solutions for energy generation, environmental remediation, and biomedical applications. In this review, we comprehensively explore the working principles of BES, highlighting the critical role of microbial electron transfer mechanisms. Various BES configurations, including microbial fuel cells, microbial electrolysis cells, and microbial desalination cells, are evaluated for their operational features and application potential. Special emphasis is placed on the composition and function of microbial communities at anodic and cathodic interfaces, which govern the efficiency and versatility of these systems. Emerging biomedical applications of BES are examined, spanning biosensing, point-of-care diagnostics, implantable medical devices, and bioelectric stimulation. Additionally, the role of BES in environmental health monitoring, pollutant degradation, and even ruminant health management is discussed. Despite significant advancements, critical challenges persist, particularly in scalability, biocompatibility, and power output. Future research priorities include engineering advanced materials, optimising microbial-electrode interactions, and integrating BES with complementary technologies such as microfluidics, artificial intelligence, and hybrid energy systems. Overall, this review underscores the transformative potential of BES in addressing key global challenges in energy, healthcare, and environmental sustainability, while charting pathways for their broader commercial and clinical deployment