Jonathan Cooper

eLife assessment
This manuscript describes a model to estimate what fraction of DNA from specific human tissues becomes cell-free DNA in plasma. This fundamental study, supported by convincing evidence, will be of great interest to the community, as the amount of DNA from a certain tissue (for example, a tumor) that becomes available for detection in the blood has significant implications for disease detection.

anonymous

Joint Public Review:
Summary 
Sender et al describe a model to estimate what fraction of DNA becomes cell-free DNA in plasma. This is of great interest to the community, as the amount of DNA from a certain tissue (for example, a tumor) that becomes available for detection in the blood has important implications for disease detection.
Strengths 
The question asked by the authors has potentially important implications for disease diagnosis. Understanding how genomic DNA degrades in the human circulation can guide towards ways to enrich for DNA of interest or may lead to unexpected methods of conserving cell-free DNA. Thus, the question "how much genomic DNA becomes cfDNA" is of great interest to the scientific and medical community. I believe this manuscript has the potential to be a widely used resource. As more data is collected on cell-free DNA yields and cellular turnover in the body, this work will only increase in importance.
Appraisal 
At this stage of the manuscript (second submission), I think the authors provide important evidence and analysis that aim to answer their research question. Previous concerns about methodology have been addressed.
Impact 
This manuscript will be highly impactful on the community. The field of liquid biopsies (non-invasive diagnostics) has the potential to revolutionize the medical field (and has already in certain areas, such as prenatal diagnostics). Yet, there is a lack of basic science questions in the field. This manuscript is an important step forward in asking more "basic science" questions that seek to answer a fundamental biological question.

What fraction of cellular DNA turnover becomes cfDNA?

Figures and data

cfDNA as a fraction of homeostatic cell turnover.

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