Using phosphorimager technology to quantitate differences in protein expression, we have investigated the modulation of protein synthesis by Mycobacterium tuberculosis in response to intracellular residence in human macrophages and, for comparison, in response to various stress conditions during extracellular growth. Proteins of M. tuberculosis growing intracellularly in human THP-1 cells and extracellularly in broth were labeled with [35S]methionine; during intracellular growth, host cell protein synthesis was inhibited with cycloheximide. The metabolically labeled proteins were separated by two-dimensional gel electrophoresis and quantitatively analyzed. Intracellular residence in macrophages induced a profound change in the overall phenotype of M. tuberculosis. The expression of at least 16 M. tuberculosis proteins was induced (at least a twofold increase compared with growth in broth) and 28 proteins repressed (at least a twofold decrease). Many of the phenotypic changes in protein expression induced during intracellular growth occurred during extracellular growth in response to stress conditions including heat-shock, low pH, and H2O2. However, the pattern of induced and repressed proteins was unique to each stress condition. Of the 16 macrophage-induced proteins, 6 were absent during extracellular growth under both normal and stress conditions. Such proteins are potential virulence determinants and/or they may be important in the cell-mediated and protective immune response to M. tuberculosis infection.