This form is for MHC Class I requests only

The request form is used for review of the request.

** Note: One request form per tetramer

Important! Your request will not be considered unless all the fields on this form are filled.

(Click here to find out when the Tetramer Resource Committee meets again to review requests.)

Be sure to register with our reagent program if you are a new client.

(Click here to download the Registration Form)

Contact and Shipping Information

Investigator's Name:
Title:
Institution:
Department:
Street Address:
City, State, ZIP
Telephone Number:
Fax Number:
E-mail: (Please note: our system can only accept one email address here on this form.)
Shipping Company / Account No.
All reagents will be shipped to the above address which cannot be a post office box.

Please Note:

The Following Tetramers cannot be provided by this facility

HLA-A*0201	SLYNTVATL	HIV gag	HLA-A*0201	ILKEPVHGV	HIV pol
HLA-A*0201	ELAGIGILTV	Mart-1	HLA-A*0201	GILGFVFTL	Flu M1
HLA-A*0201	GLCTLVAML	EBV BMLF1	HLA-A*0201	NLVPMVATV	CMV pp65
H-2K(b)	SIINFEKL	Ova	HLA-A*0201	IMDQVPFSV	gp100
HLA-A*0201	ITDQVPFSV	gp100	HLA-A*0201	KIFGSLAFL	Her-2/neu
HLA-A*0201	RLLQETELV	Her-2/neu	HLA-A*0201	VLQELNVTV	PR-1
HLA-A*0201	FLPSDFFPSV	HBV core	HLA-A*0201	YMDGTMSQV	Tyrosinase
H-2D(b)	KAVYNFATC	LCMV	Mamu-A-01	CTPYDINQM	SIV
HLA-A 0101	VTEHDTLLY	CMV	HLA-A 24021	QYDPVAALF	CMV
HLA-B 0702	TPRVTGGGAM	CMV	HLA-B 0801	ELRRKMMYM	CMV
HLA-B 3501	IPSINVHHY	CMV

(click here for more information on excluded tetramers)

Tetramer Information

MHC allele requested:
Sequence of peptide to be provided (single amino acid code):	NH₂COOH
Please provide the peptide's origin, including organism and protein
Epitope Organism (i.e. Mouse, EBV etc.)	Epitope Protein (i.e. p53, pp65 etc.)
Desired LABEL for tetramer:
- If other, requester must send label.
Select beta-2microglobulin.
****Please note that we typically fold all tetramers of every species with human beta-2microglobulin. Use of murine beta-2microglobulin may reduce the stability of the reagent. Typically staining of murine CD8+ T-cells with tetramer is NOT affected by the use of human beta-2microglobulin.

Funding and Project Information

FOR NEW AND REFILL REQUESTS: PLEASE COMPLETE ALL FIELDS BELOW (failure to complete all fields will delay review and approval process). NIH funding is not a requisite for requesting tetramers.

Title of Current Research Grant(s) or Contract supported by NIH for which tetramers will be used:
Grant or Contract Number (if any):
Please list the staff that will be using this reagent (include collaborators):
Please provide evidence of peptide binding to the requested MHC molecule. This information can be a journal article citation or data from the requestor's lab. For journal article citations, please include: name of first author, article title, journal name, publication date, volume, and page numbers. Please email any figures or references necessary for Tetramer Resource Committee to evaluate your request to TRC@niaid.nih.gov. Please include the name of the PI, as it appears on the on-line Tetramer Request form, in this email.
Positive Control to test the requested tetramer(s): Yes No Please provide a description of your positive control that you will use to test the requested tetramer. Results from T cell lines, clones or hybridomas are preferred, but assays using T cell bulk cultures are acceptable for immunodominant responses. If you do not have a positive control, please describe the method you will use to determine that the tetramer is working in your laboratory.
Research Abstract: This abstract should include a brief description of the research project, experimental system, how the tetramer reagent will be used to facilitate the research project, and a justification as to why tetramer results are needed instead of or in addition to results obtained from assays such as cytokine ELISPOTS or cytokine capture assays that do not require precise identification of MHC restriction. (limit: 1000 words)

If this is a refill request, please also answer the following questions.

Have you submitted a feedback form on your original order?
If you have not provided feedback to the NIH Tetramer Facility Manager, approval of your order could be delayed.
Please go to our online feedback form and submit a complete report.
Please provide your reason for requesting additional tetramer. (If the tetramer no longer works, please provide a brief description of how the tetramer was stored and explain the experimental conditions in which the tetramer failed to stain, including the positive and negative controls that were used in the study.)

Last updated December 28, 2006 (EVR)