Stewart Fleming

Biography

Stewart Fleming graduated in Immunology (1978) and Medicine (1980) from the University of Glasgow.  After junior hospital training posts in Glasgow he moved to a Clinical Lectureship in Pathology in the University of Southampton.  While here he completed his thesis on the Cellular Differentiation in Renal Carcinoma which was awarded MD with Honours from the University of Glasgow (1988).  He was gained Membership of the Royal College of Pathologists in 1987 and Fellowship (FRCPath) in 1997. He was awarded the Oakley Lecture of the Pathological Society of Great Britain and Ireland in 1991.  He moved to Senior Lecturer then Reader in Pathology at the University of Edinburgh in 1988 until 2000. He was appointed to the Chair of Cellular and Molecular Pathology in the University of Dundee in 2001and Honorary Consultant Pathologist to NHS Tayside.  He has been the Scottish Chairman and Executive Member of the Royal College of Pathologists, chair of the Research Committee of the Pathological Society and a member of both the WHO and International Society of Urological Pathologistscommittees for Renal cancer classification.  He has recently been elected as Chairman of the British Association of Urological Pathologists.  He has published over 130 peer reviewed articles, several textbook chapters and has edited Muir’s Textbook of Pathology (14th Edition). He has an extensive UK wide consultation practice for the diagnosis of renal tumours and is the consultant renal and transplant pathologist for NHS Tayside and NHS Fife.

Research Interest

Renal cancer is amongst the commonest malignancies affecting 6,500 new patients per year in the UK.  It is associated with a high mortality and limited success of non-surgical treatment. We have engaged in a long term study for the past 20 years identifying several of the genes which are altered in renal cell carcinoma (RCC), the commonest form of malignancy in adults and Wilms’ tumour the childhood form of the disease. Several years ago we found that RCC is caused by mutations in one of several genes which control the hypoxia signalling pathway particularly the Von Hippel Lindau gene. Our recent work has shown rather surprisingly that mutations in the nuclear encoded genes fumarate hydratase and succinate dehydrogenase B are found in subsets of RCC.  We have established the diagnostic criteria for the identification of these tumours and laboratory testing to analyse the types of mutational events further. We are currently engaged in identifying the mechanisms involved in SDHB induced tumourigenesis. One of the strongest risk factors for the development of RCC is high blood pressure.  We are researching the mechanisms behind this observation. In particular we are interested in the role of the renin angiotensin aldosterone system in driving renal epithelial proliferation.