From molecular biology to medicine

The past century has witnessed the identification and characterization of varicella-zoster virus (VZV) as a major human pathogen. Discoveries regarding the virus have accelerated rapidly during the past two decades. These discoveries have been driven, in part, by technical achievements in in vitro cultivation of the virus, by an expanding spectrum of VZV disease, by accessible diagnostics, and by targeted antiviral drug development. But a dominant force in propelling the field forward-which will no doubt dictate achievements in the coming century-is the application of molecular tools that offer unprecedented sensitivity and versatility. I intend to highlight a number of milestones in VZV molecular biology, from the first purification and characterization of VZV DNA in 1972 through the recent development of a recombinant system to modify viral elements at will. Each of these achievements has already made a direct impact on our comprehension of VZV's clinical spectrum, epidemiology, immunology, pathogenesis, and latency, and on the utility and limitations of existing antiviral and preventive strategies. The inevitable conquest of varicella and zoster will depend on these strategies, as well as on further …