Carbohydrates are ideally suited for molecular recognition. By varying the
stereochemistry of the hydroxyl substituents, the simple six-carbon, six-ox
ygen pyranose ring can exist as 10 different molecules. With the further ad
dition of simple chemical changes, the potential for generating distinct mo
lecular recognition surfaces far exceeds that of amino acids. This ability
to control and change the stereochemistry of the hydroxyl substituents is v
ery important in biology. Epimerases can be found in animals, plants and mi
croorganisms where they participate in important metabolic pathways such as
the Leloir pathway, which involves the conversion of galactose to glucose-
1-phosphate. Bacterial epimerases are involved in the production of complex
carbohydrate polymers that are used in their cell walls and envelopes and
are recognised as potential therapeutic targets for the treatment of bacter
ial infection. Several distinct strategies have evolved to invert or epimer
ise the hydroxyl substituents on carbohydrates. In this review we group epi
merisation by mechanism and discuss in detail the molecular basis for each
group. These groups include enzymes which epimerise by a transient keto int
ermediate, those that rely on a permanent keto group, those that eliminate
then add a nucleotide, those that break then reform carbon-carbon bonds and
those that linearize and cyclize the pyranose ring. This approach highligh
ts the quite different biochemical processes that underlie what is seemingl
y a simple reaction. What this review shows is that each position on the ca
rbohydrate can be epimerised and that epimerisation is found in all organis
ms.