“Self-Antigenic Universe” and Tuberculosis Vaccine Development

Background: Tuberculosis (TB) is one of the most important causes of mortality due to infectious diseases. The development of a vaccine inducing superior protection than BCG is a top priority for the future control of the disease. Methods: We reviewed the literature related with the impact of the host, microbiome and environmental elements in response to vaccination, with special emphasis on TB. Results: This review introduces the term “Self-Antigenic Universe” (SAU) which consists of “Host” & “Guests” (classical microbiota and other organisms with relatively stable presence in the host) and “Familiar Visitors”: (organisms and substances which are often present in the host). We provide multiple examples of how SAU influences the immune response to Mycobacterium tuberculosis and its impact on TB vaccine development. Conclusion: The immune response induced by antigens/epitopes present in SAU could have carrier effect and elicit specific effector and/or regulatory immune responses potentially useful for the development of new vaccines. This aspect should be considered for the development of tailored vaccines with superior efficacy for the prevention of TB.