Cell proliferation is a fundamental biological process that underpins tissue growth, repair, and regeneration, playing a pivotal role in both normal physiology and pathological conditions. The ability of cells to proliferate is intricately controlled by regulatory networks comprising transcription factors, signaling pathways, and telomerase activity. This review delves into the molecular mechanisms that govern cell proliferation, focusing on the critical signaling cascades – PI3K/Akt, MAPK, Wnt/β-catenin, and NF-κB – which orchestrate cell cycle progression and mediate cellular responses to external stimuli. Dysregulation of these pathways is linked to numerous disorders, including cancer, where unchecked proliferation drives disease progression. Special emphasis is placed on Yamanaka factors (OCT4, SOX2, KLF4, c-MYC, NANOG, and LIN28), which are instrumental in maintaining cellular pluripotency and promoting a high proliferative potential. These factors not only reprogram somatic cells into induced pluripotent stem cells (iPSCs) but also enhance regenerative capabilities, making them indispensable tools for tissue engineering and regenerative medicine. Their interaction with core signaling pathways and their ability to influence gene networks highlight their multifaceted roles in cellular biology. Telomerase, a ribonucleoprotein traditionally recognized for its function in telomere maintenance, is revisited in this review for its non-canonical roles. Emerging evidence indicates that telomerase modulates gene expression and interacts with signaling pathways to influence proliferation. These insights expand our understanding of telomerase beyond its established role in genomic stability, positioning it as a key regulator in cellular proliferation and potential therapeutic target. This review synthesizes current knowledge on these mechanisms, emphasizing their interconnectedness and translational potential. By highlighting advances in our understanding of proliferative regulation, the article underscores the therapeutic opportunities in leveraging these pathways for regenerative medicine, tissue engineering, and oncology. The ability to modulate proliferation through targeted interventions offers promise for addressing unmet clinical needs, advancing personalized medicine, and enhancing outcomes in tissue repair and cancer therapies. As research continues to uncover novel roles and interactions within these networks, the potential for developing innovative strategies to control proliferation remains vast, heralding a new era in biomedical science.
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