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University of Sydney Institutional Biosafety Committee This form is to be completed by the Principal Investigator and must be submitted by the Principal Investigator Name of Principal Investigator: Project title: Type of project proposal: □ Exempt Dealing □ NLRD □ DNIR RIMS Project ID Code: (for projects that are part of a funded research grant ) For completion by IBC. IBC Reference Number Name of IBC Chair Prof Anthony Weiss Signature Exempt Dealing application form – July 2014 Date of approval Page 1 University of Sydney Institutional Biosafety Committee – Exempt Dealing application form 1. Exemption Category – Please place an X in the appropriate box/s OGTR Mark Item # with an X 2 Description of Dealing A dealing with a genetically modified Caenorhabditis elegans, whereby: a) an advantage is not conferred on the animal by the genetic modification; and b) as a result of the genetic modification, the animal is not capable of secreting or producing an infectious agent. 3 A dealing with an animal into which genetically modified somatic cells have been introduced, if: a) the somatic cells are not capable of giving rise to infectious agents as a result of the genetic modification; and b) the animal is not infected with a virus that is capable of recombining with the genetically modified nucleic acid in the somatic cells. 3A A dealing with an animal whose somatic cells have been genetically modified in vivo by a replication defective viral vector, if: a) the in vivo modification occurred as part of a previous dealing; and b) the replication defective viral vector is no longer in the animal; and c) no germ line cells have been genetically modified; and d) the somatic cells cannot give rise to infectious agents as a result of the genetic modification; and e) the animal is not infected with a virus that can recombine with the genetically modified nucleic acid in the somatic cells of the animal. Exempt Dealing application form – July 2014 Page 2 4 1) Subject to subitem 2) below, a dealing involving a host/vector system mentioned in Part 2 of Schedule 2 and producing no more than 25 litres of GMO culture in each vessel containing the resultant culture. 2) The donor nucleic acid: a) must meet either of the following requirements: i) it must not be derived from organisms implicated in, or with a history of causing, disease in otherwise healthy human beings, animal, plants or fungi; ii) it must be characterised and the information derived from its characterisation show that it is unlikely to increase the capacity of the host or vector to cause harm; and b) must not code for a toxin with an LD50 of less than 100µg/kg; and c) must not code for a toxin with an LD50 of 100µg/kg or more, if the intention is to express the toxin at high levels; and d) must not be uncharacterised nucleic acid from a toxin-producing organism; and e) must not include a viral sequence, unless the donor nucleic acid: i) is missing at least 1 gene essential for viral multiplication that: A) is not available in the cell into which the nucleic acid is introduced; and B) will not become available during the dealing; and ii) cannot restore replication competence to the vector. 5 A dealing involving shot-gun cloning, or the preparation of a cDNA library, in a host/vector system mentioned in item 1 of Part 2 of Schedule 2, if the donor nucleic acid is not derived from either: a) a pathogen; or b) a toxin-producing organism. 2. Name and full professional address of Principal Investigator submitting proposal Name: Department: Room No: Building Name: Tel: Email: 3. Name(s) of other Principal Investigators responsible for the project. Please provide their professional addresses if different from that above. Exempt Dealing application form – July 2014 Page 3 4. Describe the aim of the work 5. Describe the main experimental procedures of the work 6. Details of biological system Note: Any substantial change in the system will require submission of another proposal (a) Describe the biological source of the donor DNA to be used – include the genus, species and strain or organ/tissue as applicable. Include the specific genes to be involved in the dealing. (b) Describe the host organism or tissue to be used – include the genus, species and strain where applicable. If not a commonly used laboratory strain, include the name of the strain from which it is derived. (c) Describe the vectors or methods to be used to transfer donor DNA to the host. Include information regarding the origin and properties of the vector and confirm that all bacterial plasmid vectors are non-conjugative. If your project involves the use of a replication defective viral vector (unable to transduce human cells), please provide an explicit description of the assay you intend to perform to exclude the presence of replication competent virus. Exempt Dealing application form – July 2014 Page 4 7. If you believe the protein/gene is characterised, and unlikely to increase the capacity of the host or vector to cause harm, briefly explain why, referring to what is known about its structure, function and/or genetics. 8. Does the DNA encode a toxin? □ Yes □ No If yes, please provide the LD50 9. Where will this work be conducted? Please provide Room Number, Building Name and Building Code. 10. Do you have approval to use this facility? Yes [ ] No [ ] 11. Proposed date of commencement of work. 12. Likely duration of work. 13. Signature of Principal Investigator submitting this proposal. Date Exempt Dealing application form – July 2014 / / Page 5