text: 2,3-Bisphosphoglycerate or 2,3-BPG (formerly named 2,3-diphosphoglycerate or 2,3-DPG) is an organophosphate formed in red blood cells during glycolysis and is the conjugate base of 2,3-bisphosphoglyceric acid. The production of 2,3-BPG is likely an important adaptive mechanism, because the production increases for several conditions in the presence of diminished peripheral tissue O availability, such as hypoxemia, chronic lung disease, anemia, and congestive heart failure, among others, which necessitate easier oxygen unloading in the peripheral tissue. High levels of 2,3-BPG shift the curve to the right (as in childhood), while low levels of 2,3-BPG cause a leftward shift, seen in states such as septic shock, and hypophosphataemia. In the absence of 2,3-BPG, hemoglobins affinity for oxygen increases. 2,3-BPG acts as a heteroallosteric effector of hemoglobin, lowering hemoglobins affinity for oxygen by binding preferentially to deoxyhemoglobin. An increased concentration of BPG in red blood cells favours formation of the T (taut or tense), low-affinity state of hemoglobin and so the oxygen-binding curve will shift to the right.