32A worldwide increase in the frequency of multidrug-resistant and extensively drug-33 resistant cases of tuberculosis is mainly due to therapeutic noncompliance associated 34 with a lengthy treatment regimen. Depending on the drug susceptibility profile, the 35 treatment duration can extend from 6 months to 2 years. This protracted regimen is 36 attributed to a supposedly non-replicating and metabolically inert subset of the 37 Mycobacterium tuberculosis (Mtb) population, called 'persisters'. The mechanism 38 underlying stochastic generation and enrichment of persisters is not fully known. 39 We have previously reported that the utilization of host cholesterol is essential for 40 mycobacterial persistence. In this study, we have demonstrated that cholesterol-41 induced activation of a ribonuclease toxin (VapC12) inhibits translation by 42 targeting proT tRNA in Mtb. This results in cholesterol-specific growth modulation 43 that increases the frequency of the generation of persisters in a heterogeneous Mtb 44 population. Also, a null mutant strain of this toxin (ΔvapC12) failed to persist and 45 demonstrated an enhanced growth phenotype in a guinea pig model of Mtb 46 infection. Thus, we have identified a novel strategy through which cholesterol-47 specific activation of a toxin-antitoxin (TA) module in Mtb enhances persister 48 formation during infection. In addition to identifying the mechanism, the study 49 provides opportunity for targeting persisters, a new paradigm facilitating 50 tuberculosis drug development. 51 52 53 54 55 56 57 58 128the cholesterol-rich media. We have observed a decrease in the replication and metabolic 129 rates of wild-type (WT) H37Rv grown in the cholesterol-rich media by ten-and three-130 fold, respectively, compared with (WT) H37Rv grown in the glycerol-rich media ( Fig. 131 1A, 1B). An in-vitro time-kill curve assay revealed a cholesterol-specific increase in the 132 frequency of the generation of a rifamycin-tolerant sub-population (Fig. 1C). The TA loci 133 across bacterial species regulate growth (21,(29)(30)(31), therefore we speculated the 134 aforementioned phenotype to be regulated by one of the Mtb TA loci. For that we 135 analysed the data of a transposon mutagenesis screening performed in Mtb H37Rv to 136 identify genes essential for growth in a cholesterol-rich environment(32). Through 137