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: Atorvastatin (Ator), is the treatment of choice for reducing blood cholesterol. Most adverse effects associatedwith Statins therapy are muscle-related. Alfacalcidol (ALF), a vitamin D analog commonly used in osteoporosis; showedbeneficial effects beyond the skeleton including muscle.Aim of the work: Investigating the possible protective effect of ALF in Atorvastatin induced myopathy in rats.Materials and Methods: Twenty-one adult male albino rats were divided equally into 3 groups: Group I (control). GroupΙΙ (Ator): received Atorvastatin (10 mg/kg/day). Group ΙΙΙ (Ator-ALF): received Ator concomitantly with Alfacalcidol(0.5 μg/kg/day). After 4 weeks of daily oral medications administration, blood samples from all rats were analyzed for creatinephosphokinase (CPK). The middle parts of biceps femoris muscles were processed for paraffin blocks for Hematoxylin andEosin stain and cytochrome C immunohistochemical stain that subjected to morphometric and statistical studies. Moreover,resin blocks were processed for semithin and ultrathin sections examination.Results: In group II, light microscopic examination revealed fragmented and tapered muscle fibers, in addition to loss ofregular pattern of transverse striation. Many fibers in transverse section acquired an irregular outline. Statistically, elevatedCPK level, decreased mean muscle fiber diameter and increased mean area % of cytochrome C immunoreactivity comparedto the control were recorded. Electron microscopic examination showed dissolution of many myofibrils and mitochondriaeither disfigured giant or with destructed cristae. However, group III showed muscle fibers that are almost comparable to thecontrol group with clear transverse striations. That is confirmed statistically by decreased CPK level, increased mean musclefiber diameter and decreased mean area % of cytochrome C immunoreactivity versus group II. While ultrastructurally, fewareas of myofibrillar dissolution were noted.Conclusion: Alfacalcidiol has a protective effect on Ator induced myopathy confirmed by the biochemical analysis, light andelectron microscopic examination as well as via morphometric studies.

Can Alfacalcidol ameliorate Atorvastatin-induced myopathy in adult male rats? A histological study