Uses of the lymphocytes to monocytes ratio

To follow up a presentation topic of Part 2 of Reversal of aging and immunosenescent trends with sulforaphane, here are a few papers no earlier than 2015 that address the ratio of lymphocytes to monocytes (LMR), or its reciprocal MLR. Because inquiring minds want to know. 🙂

  1. Monocyte heterogeneity and functions in cancer

    “The ratio of lymphocytes to monocytes has emerged as a prognostic factor, including for B cell lymphoma, colorectal cancer, lung cancer, and ovarian cancer. For example, in patients with stage III colon cancer, a higher lymphocyte to monocyte ratio was associated with increased time to recurrence and overall survival.”

  2. Distinct Transcriptional and Anti-Mycobacterial Profiles of Peripheral Blood Monocytes Dependent on the Ratio of Monocytes: Lymphocytes

    “Our observation of monocyte functional and transcriptional differences dependent on the ML ratio (but on neither constituent alone) suggests that qualitative differences in monocytes are better reflected by the ML ratio than by monocyte counts alone, potentially explaining epidemiologic associations of the ratio. The ML ratio was associated with mycobacterial growth in vitro (β = 2.23, SE 0.91, p = 0.02). The significant enrichment of interferon signalling we found supports a common role for type I and II interferons in altering the ML ratio and monocyte function sufficiently to explain altered disease course, consistent with the central role of interferons in mycobacterial and inflammatory diseases. In humans, myeloid-biased HSC accumulate with age and explain the relative increase in myeloid cells in blood with age. Therefore changes in ML ratio in blood are likely a marker of changes in the frequency of lineage-biased HSC.”

  3. Monocyte–lymphocyte ratio is a valuable predictor for diabetic nephropathy in patients with type 2 diabetes

    “T2D patients without diabetic-related complications had higher MLR than control patients. MLR was significantly higher in DN patients than in T2D patients without diabetic-related complications.”

  4. Monocyte lymphocyte ratio predicts the new-onset of chronic kidney disease: A cohort study

    “Increased baseline MLR is strongly associated with the risk of new-onset CKD in people with normal or near-normal kidney function at baseline. Inflammatory markers such as interleukin are difficult to be measured by primary medical care. Therefore, search for simpler inflammatory markers to predict the risk of CKD. MLR represent[s] the state of balance between inflammatory activators and inflammatory regulators. The higher the ratio, the greater the imbalance, the more severe the inflammatory response and the stronger the immune suppression. In addition to increasing the risk of new-onset CKD, our study found MLR was positively related to inflammatory factors, such as leukocytes, neutrophils, NLR, PLR and platelet distribution width. In addition, MLR was positively correlated with age, blood pressure and BMI. However, there was no significant correlation between MLR and fasting plasma glucose in non-diabetic participants. A total of 11280 participants (6592 male and 4688 female) were enrolled in this longitudinal study.”


A LMR of 5 and a MLR of 0.2 are easy-to-measure heuristics, adequate for screening people. These ratios can be used along with many other measurements as starting points to investigate underlying causes.

Item 1 described how LMR also has prognostic value for cancers. The other studies used MLR as a biomarker for the future course of inflammatory diseases per:

“The higher the ratio, the greater the imbalance, the more severe the inflammatory response and the stronger the immune suppression.”


I’d seen the below presentation graphic several times since September 2019. My reaction was “Oh, that’s interesting” each time.

On Friday I understood it: This was what resetting your internal environment looked like.

Did my paradigm change? Yes, among other things, and all of that allowed me to see.

An environmental signaling paradigm of aging provided evidence up through 2015 for its hypothesis and framework. Its treatments’ capabilities to “reset to different age-phenotypes will be tested as the 2020 study underlying A rejuvenation therapy and sulforaphane is tested.

Caution is warranted before getting carried away with ratio analyses of a 9-subject pilot study. Are hormone ratios useful in explaining health? Behavior? Neurobiology? Anything? recommended:

“Analysis of the individual variables offers more information and a more accurate picture of the underlying relationships.

Ratios should either be analyzed with non-parametric techniques, or be log-transformed before parametric statistical methods are applied.”

There was monocyte but not lymphocyte data in the clinical trial’s supplementary material.

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