Cytokines mediate their response via cell surface receptors that in turn activate intracellular signalling pathways and lead to gene activation, cell proliferation and differentiation. Many recent studies have shown that cytokine and cytokine receptor pathways are frequently mutated in disease, thus shedding light on the generation of the inflammatory response, specific immunity and mechanisms of haematopoiesis. Many approaches are being used to translate this basic research into successful therapies and although host immune responses involve many different cells and crucial pathways, modulation of therapeutic responses can be induced or inhibited by, targeting a single cytokine. This review summarises current knowledge of cytokine pathways in disease and the use of cytokine- or receptor-directed therapy to exploit the immune response to disease.