The PFKFB4 gene encodes a bifunctional enzyme that plays a critical role in regulating the concentration of fructose-2,6-bisphosphate (F2,6BP), an important modulator of glycolysis and gluconeogenesis. Below is further detail based on your requests:

### 1. Associated Genes:
PFKFB4 is associated with several other genes involved in glycolysis, cancer metabolism, and signaling pathways. Although specific genes are not always listed, wider interactions can be inferred. Some genes that may be associated include:

- **PFKFB2** and **PFKFB3**: Other members of the PFKFB family, which also regulate F2,6BP levels.
- **HK2 (Hexokinase 2)**: Interacts with glycolytic pathways.
- **PKM2 (Pyruvate Kinase M2)**: Important for tumor metabolism.
- **PIK3CA (Phosphoinositide-3-kinase catalytic subunit alpha)**: Part of the signaling pathways that can regulate PFKFB4 expression indirectly.
- Genes encoding for hypoxia-inducible factors (HIF1A, HIF2A) which can induce PFKFB4 under hypoxic conditions.

### 2. Aging and Age-related Diseases:
While specific research directly tying PFKFB4 to aging or age-related diseases may be limited, there are general considerations:

- **Cancer**: As cancer prevalence increases with age, and given that PFKFB4 is highly expressed in cancer cells, it may indirectly contribute to the metabolic adaptations seen in aging tissues, particularly those that undergo oncogenic transformation.
- **Metabolic Disorders**: Age-related changes in metabolism may affect glycolytic regulation, including that by PFKFB4. Dysregulation of glycolysis is implicated in conditions such as diabetes and obesity, which are prevalent in older populations. 

### 3. Drug Interactions:
While there may not be specific drugs currently targeting PFKFB4, potential compounds that affect glycolytic pathways could indirectly interact. This includes:

- **2-deoxy-D-glucose**: An inhibitor of glycolysis, which may affect F2,6BP levels and, by extension, impact PFKFB4 activity indirectly.
- **AMPK activators**: Since AMPK signaling can intersect with metabolic pathways involving PFKFB4, drugs like metformin, commonly used in diabetes treatment, might have a downstream effect on this gene.
- **Oncogenic inhibitors**: Various chemotherapy agents may target signaling pathways that are linked to the expression of PFKFB4.

### 4. Pathways and Biological Processes:
PFKFB4 is involved in several key metabolic pathways:

- **Glycolysis**: There is a direct role in the regulation of the glycolytic pathway through modulation of F2,6BP, thus influencing glucose metabolism.
- **Regulation of Metabolism in Cancer**: By being crucial for the survival of cancer cells in hypoxic conditions, it participates in metabolic adaptation in tumors.
- **Hypoxia Response**: PFKFB4 expression is regulated by hypoxia-inducible factors (HIFs), linking it with cellular responses to oxygen availability.
- **Cell Proliferation**: The control of energy production through glycolysis is vital for cell growth and division, associating PFKFB4 with processes of cellular proliferation, particularly in cancer biology.

### Summary:
In conclusion, PFKFB4 is a significant player in glycolytic regulation, particularly under conditions of hypoxia, making it a potential target for cancer treatment. Its associations with other metabolic genes and roles in cancer survival under harsh conditions underline its importance in metabolic pathways, aging, and potential therapeutic interventions.
