The interplay between neutrophils and endothelial cells allows ANCA to become pathogenic and results in uncontrolled inflammation in the vessel wall. This review presents an overall view on neutrophil-endothelial interaction during inflammation with a focus on ANCA-associated vasculitis, and summarizes the effector mechanisms which cause vascular damage in AAV. In addition, potential elements for disease intervention based on this process are discussed. (C) 2011 Elsevier B.V. All rights reserved.