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.