SirT1 is an NAD-dependent histone deacetylase that regulates gene expression, differentiation, development, and organism life span. Here we investigate the function of SirT1 in human chondrocytes derived from osteoarthritic patients. Elevation of SirT1 protein levels or activity in these chondrocytes led to a dramatic increase in cartilage-specific gene expression, whereas a reduction in SirT1 levels or activity significantly lowered cartilage gene expression. SirT1 associated with the cartilage-specific transcription factor Sox9, enhancing transcription from the collagen 2(␣1) promoter in a Sox9-dependent fashion. Consistent with this association, SirT1 was targeted to the collagen 2(␣1) enhancer and promoter, which in turn recruited the coactivators GCN5, PGC1␣, and p300. This led to elevated marks of active chromatin within the promoter; that is, acetylated histone K9/K14 and histone H4K5 as well as trimethylated histone H3K4. Finally, alterations in the NAD salvage pathway enzyme nicotinamide phosphoribosyltransferase led to changes in NAD levels, SirT activity, and cartilage-specific gene expression in human chondrocytes. SirT1, nicotinamide phosphoribosyltransferase, and NAD may, therefore, provide a positive function in human cartilage by elevating expression of genes encoding cartilage extracellular matrix.Transcriptional control over cartilage-specific gene expression plays a critical role in maintenance of the chondrocyte phenotype (1). Much effort has, therefore, gone into the characterization of chondrocyte-specific transcription factors such as Sox9, -5, and -6 (28). However, it is likely that other factors such as chromatin-modifying enzymes play important roles in controlling cartilage-specific gene expression. Chromatinmodifying enzymes, which include the histone acetyltransferases (HATs) 2 and the histone deacetylases (HDACs) can act as potent transcriptional coactivators and corepressors, respectively, for a variety of genes (2). HATs modify the core histones through acetylation of lysine residues, thereby relaxing chromatin for transcription initiation and elongation (3). HDACs remove the acetyl groups, leading to chromatin condensation and transcriptional repression (4). Additionally, acetylation and deacetylation of transcription factors provide another level of regulation over gene expression (2). In some contexts HDACs are more sensitive to environmental or developmental cues than the HATs and can provide a regulatory role in transcription. In this regard, HDACs have been demonstrated to control both cell proliferation and differentiation through the deacetylation of transcription factors, cytoplasmic proteins, and histones (5, 6). Although HDACs are critically involved in diverse biological processes, their function in chondrocyte biology and cartilage diseases have only recently been explored. Recent work indicates that inhibition of HDACs reduces the expression of matrix metalloproteinase in chondrocytes and fibroblasts (7) and, therefore, inhibits arthritis progression in animal models...