The positive transcription elongation factor b (P-TEFb) is involved in physiological and pathological events including inflammation, cancer, AIDS, and cardiac hypertrophy. The balance between its active and inactive form is tightly controlled to ensure cellular integrity. We report that the transcriptional repressor CTIP2 is a major modulator of P-TEFb activity. CTIP2 copurifies and interacts with an inactive P-TEFb complex containing the 7SK snRNA and HEXIM1. CTIP2 associates directly with HEXIM1 and, via the loop 2 of the 7SK snRNA, with P-TEFb. In this nucleoprotein complex, CTIP2 significantly represses the Cdk9 kinase activity of P-TEFb. Accordingly, we show that CTIP2 inhibits large sets of P-TEFb-and 7SK snRNA-sensitive genes. In hearts of hypertrophic cardiomyopathic mice, CTIP2 controls P-TEFb-sensitive pathways involved in the establishment of this pathology. Overexpression of the β-myosin heavy chain protein contributes to the pathological cardiac wall thickening. The inactive P-TEFb complex associates with CTIP2 at the MYH7 gene promoter to repress its activity. Taken together, our results strongly suggest that CTIP2 controls P-TEFb function in physiological and pathological conditions. D iscovered in 1995 (1), P-TEFb (CyclinT1/Cdk9) is involved in physiological and pathological transcriptionally regulated events such as cell growth, differentiation, cancer, cardiac hypertrophy, and AIDS (for review, see refs. 2 and 3). It has been suggested to be required for transcription of most RNA polymerase II-dependent genes. However, a recent study suggests that a subset of cellular genes are distinctively sensitive to Cdk9 inhibition (4). P-TEFb is dynamically regulated by both positive and negative regulators. In contrast to Brd4, which is associated with the active form of P-TEFb (5, 6), the 7SK small nuclear RNA (7SK snRNA) and HEXIM1 inhibit Cdk9 activity in the inactive P-TEFb complex (7-10). P-TEFb elongation complexes are crucial for HIV-1 gene transactivation and viral replication. Recently, new P-TEFb complexes containing the HIV-1 Tat protein have been characterized (11, 12), providing evidence for the recruitment of an inactive Tat/P-TEFb complex to the HIV-1 promoter (13). However, defining the diverse nature and functions of the different P-TEFb complexes will require further investigations. The cellular protein CTIP2 (Bcl11b) has been highlighted as a key transcription factor for thymocyte (14,15) and neuron development (16), odontogenesis (17), cancer evolution (18), and HIV-1 gene silencing (19). Besides AIDS, hypertrophic cardiomyopathy is a well-described P-TEFb-dependent pathology (for review, see refs. 20 and 21).Here, we report that CTIP2 represses P-TEFb function as part of an inactive P-TEFb complex. In hearts of hypertrophic cardiomyopathic mice, CTIP2 controls P-TEFb-sensitive pathways involved in the establishment of this pathology. Together with the inactive P-TEFb complex, CTIP2 associates with the β-myosin heavy chain promoter to repress its activity. Thereby, CTIP2 might contrib...