Stimulation with phytohemagglutinin of the leukocytes from six of the seven known individuals with UDP-galactose 4-epimerase (= UDP-glucose 4-epimerase; EC 5.1.3.2) deficiency consistently resulted in the appearance of e imerase activity in the cultured cells. A long-term lymphoblast culture derived from one proband also contained an active epimerase enzyme. A comparison of the properties of this enzyme with those of epimerase produced by control lymphoblast lines revealed comparable Km values for UDPgalactose and NAD and identical behavior on polyacrylamide electrophoresis. However, a difference in the NAD requirement for heat stability at 400 provided some evidence for a structural defect in this enzyme. Possible explanations for the appearance of UDP-galactose 4-epimerase activity in stimulated lymphocytes include an increased rate of synthesis of a mutant enzyme and a derepression of an epimerase locus during lymphocyte transformation. The establishment of long-term lymphoblast lines from individuals with inborn errors of metabolism has proved to be a useful technique for the study of specific metabolic defects in cell culture (1, 2). These cells tend to maintain their individual genetic characteristics (3) and have a normal diploid chromosome complement. The initial intent of the present investigation was to study the effect of UDP-galactose 4-epimerase (= UDP-glucose 4-epimerase; EC 5.1.3.2) deficiency on the structure and metabolism of human lymphoblast cells in continuous culture. This enzyme defect (4), inherited as an autosomal recessive disorder (5), has been discovered in the peripheral blood cells of seven probands in three families and is characterized by elevated levels of erythrocyte galactose 1-phosphate (B. Steinmann et al., in preparation). Although there do not appear to be any associated clinical abnormalities in these individuals, deficiency of UDP-galactose 4-epimerase, which catalyzes the reaction UDP-galactose UDP-glucose, is known to result in marked abnormalities of cell wall synthesis in bacteria (6, 7) and has been postulated to be of serious consequence for mammalian cells (8).We found, however, that a lymphoblast line established from a human homozygote for this disorder contained an active epimerase enzyme which was not present in her peripheral blood lymphocytes. This called into question the role of lymphocyte transformation in the expression of epimerase activity. Therefore, we undertook further studies into the effect of the mitogen phytohemagglutinin (PHA) on the appearance of epimerase activity in deficient leukocytes and on the specific activity of epimerase in isolated normal lymphocytes. In addition, properties of the enzyme produced by the long-term lymphoblast line from a proband were com- (9) and washed in the same manner. All cultures contained 106 mononuclear cells per ml of complete medium, which consisted of RPMI 1640 supplemented with 20% fetal calf serum (GIBCO), 2 mM L-glutamine (Flow Laboratories), 100 units/ml of penicillin, 100 ,ug/ml of streptomycin...