The integration of genetic and epigenetic information is essential for a comprehensive understanding of genome function and regulation. Traditional sequencing methods often fall short in capturing both genetic variants and epigenetic modifications such as 5‑methylcytosine (5mC) and 5‑hydroxymethylcytosine (5hmC) simultaneously. Recent advances in 6-base sequencing have enabled the simultaneous, base-resolution detection of canonical bases and key cytosine modifications in a single workflow. This review explores the biological significance of 5mC and 5hmC, discusses current methods to achieve 6-base sequencing, and highlights recent applications in academic and clinical settings.

The 6- base genome reveals novel 5mC and 5hmC biomarkers enabling the detection of neurological disease from subnanogram quantities of CSF cfDNA
The duet technology uses a hairpin approach to provide simultaneous,
high accuracy genetics and epigenetics, including distinguishing 5hmC to
5mC. from a single low input sample.

