Abstract
Embryonic stem cells (ESCs) possess remarkable pluripotency and self-renewal capacity, making them a cornerstone of regenerative medicine. A defining yet underappreciated feature of ESCs is their attenuated innate immune response, characterized by suppressed expression of pattern recognition receptors, cytokines, and interferons. While this immune hyporesponsiveness helps preserve pluripotency and rapid proliferation during early embryogenesis, it also presents both challenges and opportunities for clinical application. This review summarizes recent findings on the molecular mechanisms underlying the innate immune deficiency of ESCs, including underdeveloped pathogen–sensing machinery and deficiencies in downstream signaling. We further explore the biological significance of this immune state in embryonic development and its implications for stem cell-based therapies. Specifically, we discuss how immune silence can mitigate inflammation during transplantation and be harnessed to improve mRNA-based differentiation and cancer vaccine strategies. Lastly, we highlight the challenges in balancing immune activation with stemness and outline future directions for optimizing ESCs-based therapeutics. A better understanding of ESC immunobiology will enable safer and more effective applications in regenerative medicine, oncology, and immunotherapy.