Cardiovascular complications are the main cause of mortality and morbidity in the diabetic patients, in whom changes in myocardial structure and function have been described. Numerous molecular mechanisms have been proposed that could contribute to the development of a cardiac damage. In this regard, angiotensin II (Ang II), a proinflammatory peptide that constitutes the main effector of the renin-angiotensin system (RAS) has taken a relevant role. The aim of this review was to analyze the role of Ang II in the different biochemical pathways that could be involved in the development of cardiovascular damage during diabetes. We performed an exhaustive review in the main databases, using the following terms: angiotensin II, cardiovascular damage, renin angiotensin system, inflammation, and diabetes mellitus. Classically, the RAS has been defined as a complex system of enzymes, receptors, and peptides that help control the blood pressure and the fluid homeostasis. However, in recent years, this concept has undergone substantial changes. Although this system has been known for decades, recent discoveries in cellular and molecular biology, as well as cardiovascular physiology, have introduced a better understanding of its function and relationship to the development of the diabetic cardiomyopathy.

Camelids (camels, dromedaries, alpacas, llamas, and vicuZas) contain in their serum conventional heterodimeric antibodies as well as antibodies with no light chains (L) in their structure and composed of only heavy chains (H), called as HcAbs (heavy chain antibodies). Variable fragments derived from these antibodies, called as VHH or nanoantibodies (Nbs), have also been described. Since their discovery, Nbs have been widely used in the fields of research, diagnostics, and pharmacotherapy. Despite being approximately one-tenth the size of a conventional antibody, they retain similar specificity and affinity to conventional antibodies and are much easier to clone and manipulate. Their unique properties such as small size, high stability, strong antigen binding affinity, water solubility, and natural origin make them suitable for the development of biopharmaceuticals and nanoreagents. The present review aims to describe the main structural and biochemical characteristics of these antibodies and to provide an update on their applications in research, biotechnology, and medicine. For this purpose, an exhaustive search of the biomedical literature was performed in the following databases: Medline (PubMed), Google Scholar, and ScienceDirect. Meta-analyses, observational studies, review articles, and clinical guidelines were reviewed. Only original articles were considered to assess the quality of the evidence.

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La diabetes mellitus (DM) es una enfermedad metabólica caracterizada por hiperglucemia, la cual ocurre como consecuencia de defectos en la acción de la insulina sobre su receptor, en la secreción de insulina o en ambas. La hiperglucemia crónica se asocia con daño, disfunción e insuficiencia a largo plazo de diferentes órganos, especialmente ojos, riñones, nervios, corazón y vasos sanguíneos. Es una enfermedad que ha alcanzado proporciones epidémicas. La última edición del Atlas de la Federación Internacional de Diabetes (FID) muestra que 463 millones de adultos viven actualmente con DM y se estima que habrá 578 millones de adultos con DM para el año 2030 y 700 millones para 2045. La prevalencia de DM (en adultos de 20-79 años) en América Central y América del Sur fue de 8,5% en 2019 y se prevé que para 2030 será de 9,5 y de 9,9% para el año 2045.