Tufts University & Tufts Medical Center
Institutional Biosafety Committee (IBC)
Tel: 617-636-4142, Fax: 617-636-8354
E-mail: ibc-office@tufts.edu
Website: http://viceprovost.tufts.edu/ibc/
Please return this form to the IBC Office via email to IBC-office@tufts.edu.
If you have any questions, please contact the IBC Office at 617-636-4142 or via email.
Principal Investigator:
Registration #
Registration Title
C. Genetically modified animals. Required for each genetically modified strain used. “Use” includes creation of the
strain OR breeding of already created mutants. For strains created at this institution, IBC approval is required
PRIOR to initiation. For strains that are created elsewhere and used for further breeding here, IBC notification is
required. For strains that are created elsewhere and will not be involved in breeding at this institution, no IBC
involvement is necessary. Review IBC Policy on Genetically Engineered Mutants.
1. Confirm here
that neither parental transgenic rodent contains the following genetic modifications: (i)
incorporation of more than one-half of the genome of an exogenous eukaryotic virus from a single family of
viruses; or (ii) incorporation of a transgene that is under the control of a gammaretroviral long terminal repeat
(LTR); and the transgenic rodent that results from this breeding is not expected to contain more than one-half of
an exogenous viral genome from a single family of viruses.
2. List the gene(s) (or family) that will be introduced into the germ line and provide a brief description of its
encoded gene products and known function. For each strain, provide the: a) transgene source; b) vector used; and
c) if a toxin or other hazardous agent is encoded (if not, state “no” as confirmation).
3. Describe the expected clinically-relevant phenotype(s). Clarify any potential detrimental effects to the animals’
health.[If unknown, please provide an educated guess based on the known function of the gene(s)]