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Original Article
NOVA1 Activation Modulates the Tumor Immune Microenvironment Through STING Phosphorylation in Head and Neck Squamous Cell Carcinoma
Sehui Kim1,2orcid , Hyang Mi Kim1, Jae Min Bae3, Sun Och Yoon1orcid

DOI: https://doi.org/10.4143/crt.2025.333 [Accepted]
Published online: June 18, 2025
1Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
2Department of Pathology, Korea University Guro Hospital, Seoul, Korea
3Yonsei University College of Medicine, Seoul, Korea
Corresponding author:  Sun Och Yoon
Tel: 82-2-2228-1763 
Email: soyoon@yuhs.ac
Received: 22 March 2025   • Accepted: 17 June 2025
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Purpose
Neuro-oncological ventral antigen 1 (NOVA1), a neuron-specific pre-mRNA splicing factor, is involved in neuronal development and oncogenesis. NOVA1 overexpression is associated with favorable prognosis in head and neck squamous cell carcinoma (HNSCC) and gastric adenocarcinoma, whereas its downregulation correlates with poor outcomes. High NOVA1 levels in these cancers correlate with increased CD3+ and CD8+ T lymphocyte densities, suggesting involvement in tumor immune-inflammatory signals. This study explores NOVA1's role in regulating the immune-inflammatory cGAS-STING pathway in HNSCC cells and clinical tissues.
Materials and Methods
HNSCC cell lines (FaDu, YD-10B, SNU-1066, and SNU-1076) were transfected with NOVA1 and poly(dA:dT). Quantitative real-time PCR (qRT-PCR) and Western blot analysis were used to assess gene/protein expression. Enzyme-linked immunosorbent assay (ELISA) quantified cytokine levels, and immunoprecipitation assessed protein interactions. Clinical tissue samples from 234 HNSCC patients were analyzed using immunohistochemistry to correlate NOVA1 and STING pathway markers with immune cell infiltration.
Results
NOVA1 overexpression in HNSCC cells increased phosphorylation of STING (p-STING) without altering cGAS or TBK1. Immunoprecipitation showed an interaction between NOVA1 and p-STING. Overexpression of NOVA1, particularly with poly(dA:dT) treatment, tended to elevate CCL5 and CXCL10 expression. In clinical samples, NOVA1 expression strongly correlated with p-STING levels (r=0.749, p<0.001). Higher NOVA1 and p-STING expressions were linked to increased infiltration of CD3+ T cells, CD8+ T cells, and FOXP3+ regulatory T cells.
Conclusion
NOVA1 modulates the cGAS-STING pathway through STING phosphorylation and associated immune responses in HNSCC, providing potential therapeutic target for enhancing anti-tumor immunity.

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    NOVA1 Activation Modulates the Tumor Immune Microenvironment Through STING Phosphorylation in Head and Neck Squamous Cell Carcinoma
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