SUMMARY:TNF-␣ plays a key role in rheumatoid arthritis, but its effect on chondrocyte survival is still conflicting. In the present study, we tested how TNF-␣ influences chondrocyte survival in response to nitric oxide (NO)-related apoptotic signals, which are abundant during rheumatoid arthritis. Human primary articular chondrocytes or cartilage explants were pretreated with TNF-␣ for 24 hours and then treated with the proapoptotic NO donor sodium-nitro-prusside (SNP) for an additional 24 hours. TNF-␣ pretreatment markedly protected chondrocytes from SNP-induced cell death. Preincubation of chondrocytes with TNF-␣ inhibited both SNP-induced high-molecular weight DNA fragmentation and annexin V-FITC binding. Of interest, TNF-␣ induced persistent nuclear factor-B (NF-B)-DNA binding activity even in the presence of SNP, mirroring apoptosis protection effects. Both the TNF-␣ antiapoptotic effect and NF-B-DNA binding activity were significantly inhibited by NF-B inhibitors, Bay 11-7085, MG-132, and adenovirus-expressing mutated IB-␣. Phosphatidylinositol-3 kinase inhibitor LY 294002 also markedly inhibited the antiapoptotic effect of TNF-␣. In primary chondrocytes, TNF-␣ induced expression of the antiapoptotic protein Cox-2, which persisted in the presence of SNP, and a specific Cox-2 inhibitor significantly blocked the TNF-␣ protective effect. We therefore conclude that TNF-␣-mediated protection of chondrocytes from NO-induced apoptosis acts through NF-B and requires Cox-2 activity. (Lab Invest 2002, 82:1661-1672.C artilage loss associated with rheumatoid arthritis (RA) leads to irreversible joint dysfunction. Cartilage destruction results from metalloproteinasedependent matrix degradation and nitric oxide (NO)-induced chondrocyte apoptosis (Amin et al, 1999;Blanco et al, 1995;Lotz et al, 1999;Sakurai et al, 1995). Extracellular matrix modifications may also lead to chondrocyte apoptosis, as was shown in collagen II-deficient mice (Yang et al, 1997). Because chondrocytes are the only cells in the cartilage and the only matrix producers, their survival is the focus of many recent investigations (Blanco et al, 1998;Colnot et al, 2001;Hashimoto et al, 1998;Kim and Song, 1999).The proinflammatory cytokines TNF-␣ and IL-1 are indirectly responsible for cartilage degradation and chondrocyte death because they stimulate the synthesis and release of metalloproteinases and NO from monocytes-macrophages, synoviocytes, and chondrocytes. In vitro, however, conflicting results have been reported about the effect of proinflammatory cytokines on chondrocyte apoptosis (Aizawa et al, 2001;Blanco et al, 1995;Fischer et al, 2000;Kuhn et al, 2000;Lotz et al, 1999).Many TNF-␣ biologic activities are mediated by nuclear factor-B (NF-B). NF-B is maintained in the cytoplasm of most cell types under an inactive form associated with an inhibitor from the IB family, such as the ubiquitous IB-␣ protein. After cellular stimulation with TNF-␣, NF-B nuclear activity is rapidly induced as a consequence of IKK kinase activation and IB-␣ phosphory...