The adaptation of the tubercle bacillus to the host environment is likely to involve a complex set of gene regulatory events and physiological switches in response to environmental signals. In order to deconstruct the physiological state of Mycobacterium tuberculosis in vivo, we used a chemostat model to study a single aspect of the organism's in vivo state, slow growth. Mycobacterium bovis BCG was cultivated at high and low growth rates in a carbon-limited chemostat, and transcriptomic analysis was performed to identify the gene regulation events associated with slow growth. The results demonstrated that slow growth was associated with the induction of expression of several genes of the dormancy survival regulon. There was also a striking overlap between the transcriptomic profile of BCG in the chemostat model and the response of M. tuberculosis to growth in the macrophage, implying that a significant component of the response of the pathogen to the macrophage environment is the response to slow growth in carbon-limited conditions. This demonstrated the importance of adaptation to a low growth rate to the virulence strategy of M. tuberculosis and also the value of the chemostat model for deconstructing components of the in vivo state of this important pathogen.Despite more than a century of research into tuberculosis (TB), this disease remains the number one killer due to a single infectious agent, making Mycobacterium tuberculosis one of the most successful human pathogens. A key to this bacterium's success is its ability to establish and maintain a latent infection in its human host for many decades (18). The control of TB is severely impeded by the global magnitude of latent TB. Onethird of the world's population is estimated to harbor persistent M. tuberculosis primed for reactivation and initiation of clinical disease (7). The bacterial response to the triggers of latency and reactivation are very poorly understood. Determining the mechanisms involved during the establishment, maintenance, and reactivation of latent TB is an important goal for mycobacterial researchers. Such information should lead to the development of novel therapeutics, vaccines, and diagnostic strategies targeted to persistent M. tuberculosis.In vitro modeling of M. tuberculosis provides simple experimental approaches for studying the physiology and genetic basis of TB. However, the design of adequate models is impeded by the paucity of knowledge about the biological characteristics of both the bacteria and the host environment during human TB, and therefore in vitro modelers must make simplistic assumptions about the environmental variables within the human host. Microaerophilic adaptation, nutrient starvation, drug-persistent, and extended stationary-phase models of persistent TB have been established (9). All these models provide in vitro conditions that are intended to simulate the microenvironments of the host during persistence. While these models have proved to be very valuable for studying persistence, it is unlikely that a sin...