Following infection with intracellular pathogens like mycobacteria, listeria, toxoplasma and leishmania, mononuclear phagocytes and related antigen-presenting cells (APC), i.e. dendritic cells, secrete the heterodimeric cytokine IL-12. IL-12 comprises two disulphide-linked subunits, p40 and p35, which together form the biologically active p70 hetrodimer molecule (reviewed in [1,2]). IL-12 production by macrophages and dendritic cells can also be enhanced by a T cell-dependent pathway through interaction of CD40 on the surface of the APC with CD40-ligand expressed on activated T cells. The IL-12 receptor (IL-12R), which is expressed by both natural killer (NK) cells at certain stages of development and by activated T cells, is made up of two chains called IL-12Rβ1 and IL-12Rβ2, respectively. Both receptor chains have extracellular, transmembrane and intracellular segments. Each of these receptor proteins can only bind to IL-12 with low affinity, but when co-expressed can bind IL-12 with high affinity, initiating a physiological response to this cytokine [3]. A schematic representation of the IL-12 receptor-mediated intracellular signalling pathway is illustrated in Fig. 1. Fig. 1 Binding of IL-12 to the IL-12Rβ1 and β2 chains induces phosphorylation of the kinases Tyk2 and Jak2, which associate with the cytoplasmic tails of the β1 and β2 chains, respectively. Subsequently the signal transducing ... Binding of IL-12 to activated CD4 T cells partitions them to develop and differentiate along the so-called Th1 pathway, crucially important for cell-mediated immunity against intracellular pathogens. Furthermore, acting at picomolar and subpicomolar levels on T cells and NK cells, IL-12 induces high-level production of the cytokine IFN-γ[2]. IFN-γ plays a central role in the resistance of mammalian hosts to pathogens, particularly bacteria and parasites capable of intramacrophage survival (reviewed in [4,5]). The main cells producing IFN-γ are activated Th1 cells, activated CD8 cytotoxic cells of the TC1 phenotype, and activated NK cells. Biologically active IFN-γ is a homodimer, which has a range of pleiotropic effects on a number of cell types, with the ability to modulate the function of over 200 genes. It is one of the principal macrophage-activating cytokines, and mice with disrupted IFN-γ or IFN-γ receptor (IFN-γR) genes show increased susceptibility to intracellular pathogens including Leishmania major, Listeria monocytogenes, mycobacteria and certain viruses, e.g. vaccinia virus. IFN-γ interacts with a specific cell surface receptor, which is widely expressed on most nucleated cells. The IFN-γR consists of two transmembrane proteins, namely IFN-γR1 which is a ligand-binding chain, and IFN-γR2, which is required for signal transduction. A schematic representation of the IFN-γ receptor-mediated intracellular signalling pathway is shown in Fig. 2. Fig. 2 A schematic representation of the IFN-γ receptor-mediated intracellular signalling pathways (modified from [4,5]). Two IFN-γR1 chains dimerize on binding the IFN-γ homodimer and subsequently associate with two IFN-γR2 chains. ... Key actions of IFN-γ include increased expression of MHC class I and class II proteins which enhance antigen processing and presentation, activation of mononuclear phagocytes through a multiplicity of effects, influencing IgG heavy-chain switching and modulating the production of cytokines such as IL-12, tumour necrosis factor-alpha (TNF-α) and IFN-γ itself. Following IFN-γR ligation the receptor–ligand complexes recycle into an acidified subcellular compartment, where they dissociate. Free IFN-γ is then degraded by lysosomal enzymes. The uncoupled IFN-γR1 receptors eventually relocate to the cell surface via an intracellular pool. An amino acid motif present on the intracellular domain of the IFN-γR1 close to the Jak1 association site is required for normal recycling of this receptor (Fig. 2). The above background information helps in the understanding of the clinical, pathological and immunological features of defects in the IL-12-dependent, high-output IFN-γ pathway and the laboratory methods required for identifying these defects.