In conclusion, the variability of the transcriptome of monocytes can be viewed from two perspectives. On one hand it reflects the accumulation of effects originating from the genome and the environment and may inform on a number of ongoing processes relevant to disease. On the other hand, it may reflect or anticipate differences in monocytes biology that could have pathophysiological implications. This dual perspective suggests that a better understanding of the sources of variability of the transcriptome of monocytes and other easily accessible cells, will contribute in an important way to our understanding of complex diseases.