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2,3-bisphosphoglycerate (2,3-BPG; also known as 2,3-diphosphoglycerate, 2,3-DPG) is a highly anionic organic phosphate found in human red blood cells at concentrations similar to that of hemoglobin[1][2][5][3]. It is a three-carbon isomer of 1,3-bisphosphoglycerate, produced via the Rapoport-Luebering shunt of glycolysis by the enzyme bisphosphoglycerate mutase[1][7][9]. 2,3-BPG binds preferentially to deoxyhemoglobin, stabilizing its low-oxygen-affinity (T state) conformation and thereby promoting oxygen release from hemoglobin to peripheral tissues[1][5][7]. This allosteric effect is essential for efficient oxygen delivery. 2,3-BPG also acts as a required cofactor for phosphoglycerate mutase, an enzyme of glycolysis[3]. While 2,3-BPG is critical for red blood cell physiology, it is a small metabolite rather than a classic druggable target such as a receptor or enzyme[1][2][5]. There is no evidence that approved drugs target 2,3-BPG directly. Rather, research focuses on its role in oxygen transport under physiological and pathological conditions, such as adaptation to high altitude, anemia, and hemoglobinopathies like sickle cell disease[1][3][7].
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