Cell death: from basic principles to translational developments

The precise regulation of cell death is indispensable for embryonic development, tissue homeostasis, and the pathophysiology of human disease. Dysfunctions in regulated cell death (RCD) pathways constitute a critical aetiological factor in diverse pathologies, including oncogenesis, neurodegenerative disorders, autoimmune conditions, and ischaemic injury. Substantial efforts to therapeutically target these mechanisms are therefore needed. In this review, we present a systematic analysis of the molecular machinery underlying distinct RCD processes, including apoptosis, necroptosis, pyroptosis, and multiple forms of metal-dependent cell death. We delineate how the interconnected signalling networks that govern these pathways are coordinated at the cellular and organismal levels and how their dysregulation drives disease progression. We also emphasise translating mechanistic insights into clinical practice by critically evaluating pharmacological strategies. Furthermore, this review systematically describes how an improved understanding of pathway crosstalk mechanisms, the discovery of predictive biomarkers, and advances in targeted delivery systems collectively drive the development of precision therapeutic strategies. Finally, we discuss current challenges in achieving on-target specificity and minimising off-tumour toxicity, and we outline future directions for integrating these approaches into immunomodulatory and combination frameworks. By bridging fundamental cell biology with translational medicine, this review aims to illuminate both the conceptual foundations and the clinical potential of targeting cell death in human diseases.