Einarsson, H.; Navamajiti, N.; Skov Vaagenso, C.; Pellegrini, S.; Alcaraz, N.; Thodberg, M.; Solvie, D. A.; Qiu, W.-L.; Sheth, M. U.; Greedy Escudero, M.; Gorissen, B.; Salvatore, M.; Bernstein, B. E.; Sandelin, A.; Engreitz, J. M.; Krautz, R.; Andersson, R.

Determining the activity of cis-regulatory elements (CREs) is essential for modeling gene regulation and interpreting genetic variation. Yet, current methods often lack the specificity to distinguish active regulation from permissive chromatin, the sensitivity to detect unstable enhancer RNAs, or the scalability required to profile limited input material and primary cells. Here, we introduce nucCAGE, a transcription start site (TSS) assay for profiling nuclear, capped RNAs, and PRIME, a computational framework for identifying active CREs from TSS data. Together, these methods increase sensitivity to low-abundance RNAs and enable robust detection of active regulatory elements across diverse contexts. Across multiple orthogonal functional and genetic benchmarks, including fine-mapped eQTLs, ClinVar variants, GWAS loci, and CRISPRi-tested elements, nucCAGE-derived PRIME predictions achieve superior recall compared to state-of-the-art methods while maintaining strong enrichment for phenotype-associated variation. Applying PRIME to the FANTOM5 dataset yields a comprehensive, cell-type-resolved atlas of active CREs that recapitulates known tissue-trait relationships. We demonstrate how this atlas can be used to nominate causal noncoding variants, linking immune-cell enhancer regulation of SMAD3 to asthma and NCOR2 to premature separation of placenta. Together, nucCAGE and PRIME provide a framework for high-sensitivity genome-wide discovery of active CREs and a resource for variant-to-function studies.