The locations at which vascular endothelial cells recruit leukocytes during physiological or pathological inflammatory responses are influenced by direct effects of local haemodynamics on leukocyte adhesion. However, the expression of genes by endothelial cells, and their ability to respond to inflammatory cytokines also depend on the flow forces to which they are exposed. In addition, cells of the underlying stroma can modify the phenotype and responsiveness of endothelial cells, and hence their ability to recruit leukocytes. Thus, endothelial cells are plastic in their responses, and we hypothesise that the pattern of recruitment of leukocytes to tissues is critically dependent on the variable modulation of the endothelium by the local physicochemical microenvironment.