HEALTH AND RISK ASSESSMENT



ANTISERA REQUEST FORM

Completed forms should be saved as a PDF and submitted to Comparative Medicine at CompMed@research.usf.edu

for uploading into the ARC system for IACUC consideration.

1. REQUESTING FACULTY MEMBER.

Requesting Faculty Member’s Name Department Campus Mailbox Phone

2. ALTERNATIVES, LITERATURE SEARCH, PRINCIPLES & PROCEDURES.

Indicate by checking, that:

A search for alternatives was conducted on ___________________ (date) of PubMed covering the years 20___ - 20___ ( > last 10 years) using the search terms animal, rabbit, research, pain, antiserum, antibody production, alternatives, antigen, inflammation, adjuvant, immunogen, early endpoint, anesthesia, analgesia, exsanguination, polyclonal antibodies, RIBI®, TiterMax®, MPL®, SAF®, and the specific immunogen & adjuvant_______________________________________________________

A search for alternatives was conducted on ___________________ (date) of Web of Science covering the years 20___ - 20___ (> last 10 years) using the search terms animal, rabbit, research, pain, antiserum, antibody production, alternatives, antigen, inflammation, adjuvant, immunogen, early endpoint, anesthesia, analgesia, exsanguination, polyclonal antibodies, RIBI®, TiterMax®, MPL®, SAF®, and the specific immunogen & adjuvant________________________________________________

Non-animal alternatives were considered, less sentient species were considered, and none were found suitable for antiserum production

Alternatives to painful procedures were considered, none were found suitable, and methods used in antiserum production will be continuously refined so as to reduce animal discomfort

Animal use for antiserum production does not unnecessarily duplicate previous research or existing studies

Antiserum production using NZW rabbits by Comparative Medicine in accordance with IACUC Principle XVII is requested without exception, including all administrations, observations, phlebotomies, and treatments made and recorded by Comparative Medicine, and that the requesting investigator will provide the immunizing antigen to the Facility Manager, who will in turn coordinate and supervise the service

3. ANTIGEN PREPARATION.

Name and describe the antigen(s) of interest (e.g., IL-1 receptor), and the preparation(s) (e.g., soluble, insoluble or particulate protein, or peptides conjugated to carrier proteins, or carbohydrates, etc.):

Antigen(s): Preparation(s):

4. ANIMALS.

Indicate the total number of rabbits requested (i.e., 2-4 rabbits/antigen):

5. SPECIAL CONSIDERATIONS.

Check only if applicable, that:

Complete Freund's Adjuvant (CFA) is required for this request

The searches for alternatives above includes the search terms CFA, anesthesia, exsanguination, polyclonal antibodies, adjuvant, pain, abscess, alternative adjuvants, RIBI®, TiterMax®, MPL®, SAF®, and early endpoint

The following scientific justification is provided for the use of Complete Freund’s Adjuvant:

__________________________________________________________________________________________________

Requesting Faculty Member’s Signature Date

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