All of these methods (and more, besides) can be used to emphasize text.
All clients- CAPS
- *stars*
- _old_style_underline_
- 'quotes'
- "double quotes"
- -side dashes-
- ~side tildes~
- .«{formatted symbols}».
- etc.
Most modern clients- <Ctrl-B> Bold (<Ctrl-b> turns off the last bold code)
- <Ctrl-U> Underline (<Ctrl-u> cancels the last underline code)
- <Ctrl-R> Reversed/White-on-Black (<Ctrl-r> cancels the last reverse code)
- <Ctrl-O> Normal text (cancel all currently active codes)
- <Ctrl-K>##,## ForegroundColorNumber,BackgroundColorNumber (<Ctrl-k> to cancel just the last color code)
You can, in fact, combine most of these into the same message.