Mesenchymal stem cell-derived osteochondroprogenitors express two master transcription factors, SOX9 and RUNX2, during condensation of the skeletal anlagen. They are essential for chondrogenesis and osteogenesis, respectively, and their haploinsufficiency causes human skeletal dysplasias. We show that SOX9 directly interacts with RUNX2 and represses its activity via their evolutionarily conserved high-mobility-group and runt domains. Ectopic expression of full-length SOX9 or its RUNX2-interacting domain in mouse osteoblasts results in an osteodysplasia characterized by severe osteopenia and down-regulation of osteoblast differentiation markers. Thus, SOX9 can inhibit RUNX2 function in vivo even in established osteoblastic lineage. Finally, we demonstrate that this dominant inhibitory function of SOX9 is physiologically relevant in human campomelic dysplasia. In campomelic dysplasia, haploinsufficiency of SOX9 results in up-regulation of the RUNX2 transcriptional target COL10A1 as well as all three members of RUNX gene family. In summary, SOX9 is dominant over RUNX2 function in mesenchymal precursors that are destined for a chondrogenic lineage during endochondral ossification.differentiation ͉ mesenchymal ͉ skeletal dysplasias ͉ osteoblasts ͉ transcriptional repressor D uring embryogenesis, the majority of bones are formed via endochondral ossification; mesenchymal progenitor cells differentiate into chondrocytes that are eventually replaced by osteoblasts (1, 2). It is a well coordinated process regulated by a complex transcriptional network in which the transcription factors Runx2 and Sox9 play essential roles. Runx2 is required for osteoblast differentiation and chondrocyte maturation both in vivo and in vitro (3). We and others have shown that mutations in RUNX2 cause cleidocranial dysplasia, a dominantly inherited skeletal dysplasia characterized by hypoplastic clavicles, large fontanels, dental anomalies, and delayed skeletal development (4, 5). Sox9 is a potent transcriptional activator for chondrocyte-specific genes such as Col2a1 and Col11a1, and mouse genetic studies demonstrate that it is required for the successive steps of chondrocyte differentiation and cartilage formation (6-8). Mutations in human SOX9 result in campomelic dysplasia (CMD1), a disorder characterized by generalized hypoplasia of endochondral bones (9, 10).Although Runx2 is a strong transcriptional activator for osteoblast-specific and hypertrophic chondrocyte-specific genes, its embryonic expression is present in osteochondroprogenitor cells during mesenchymal condensations as early as embryonic day 10 (E10), before overt chondrocyte differentiation or osteoblast differentiation (11, 12). Hence, a strong context-dependent inhibition of Runx2 must occur before cell fate commitment to the chondrogenic lineage. Because Sox9 is also highly expressed in all osteochondroprogenitor cells and in proliferating (prehypertrophic) chondrocytes (6), we hypothesize that, in addition to its well established role as transcriptional activator for ch...