Eukaryotic cells are remarkably adaptable entities. Whether embedded in solid tissues or freely suspended in blood or other fluids, cells principally exist in an aqueous environment but maintain a hydrophobic barrier, the plasma membrane, across which changes in the environment are detected. Utilizing specialized macromolecular components, cells can sense changes in temperature, hydrostatic pressure, oxygen tension, shear, shape, osmolarity, pH, electrical potential, electromagnetic radiation, and the concentrations of specific chemical compounds. Modes of response are equally varied, ranging from rapid secretion of stored substances to irreversible functional differentiation to self-destruction. Recent research has elucidated many of the enzymatic and genetic programs that accomplish these adaptations and suggests novel targets for therapeutic intervention.