Rl Nagel

The Influence of pH and Oxygen on the Erythrocyte Content of 2,3-Diphosphoglycerate

In 1917 Hasselbalch first demonstrated a displacement of the oxygen dissociation curve in the blood of patients with disease (HASSELBALCH [1917]), thus challenging the concept that the oxygen equilibrium of blood was constant for any given conditions of temperature and pH. Ten years later Richards and Strauss showed a rightward shift of the oxygen dissociation curve in patients with anemia (RICHARDS and STRAUSS [1927]), but could not identify the cause for the abnormality. During the next decade, studies at altitude by Dill and coworkers (DILL et al. [1931]) and Keys, Hall, and Guzman [1936] showed the same abnormality in acclimatized normal man, suggesting that the alteration might be an adaptive mechanism related to oxygen transport by the blood. In 1938 Keys and Snell demonstrated the displacement in patients with liver disease and proposed that there might be a reduction in the affinity of hemoglobin for oxygen to account for it (KEYS and SNELL [1938]).