Biomaterials, biomedical devices and engineered cell grafts can be implanted to restitute tissue anatomy and function. Such implants can either integrate physiologically, with no or minimal scarring, or induce chronic inflammation and the foreign body response, which leads to graft failure. Intravital microscopy in small animal models can be applied to visualize the structure and integration of implanted natural and synthetic fibres, metals, cells within hydrogel carriers and engineered tissues, as well as the stepwise cellular and molecular tissue response. In this Review, we discuss how intravital microscopy can reveal regenerative and pathological responses to implants, including wound healing and graft integration, which depend on the time-controlled activation of macrophages and early neovascularization, and adverse reactions, such as the foreign body response and fibrosis. The combination of improved materials designs, detection of cell signalling using molecular reporters and targeted intervention will allow the development of strategies to improve graft integration and functionality.

可以植入生物材料、生物医学设备和工程细胞移植物以恢复组织解剖结构和功能。这种植入物可以在生理上整合，没有或很少留下疤痕，或者诱发慢性炎症和异物反应，从而导致移植失败。小动物模型中的活体显微镜可用于可视化植入的天然和合成纤维、金属、水凝胶载体和工程组织内的细胞的结构和整合，以及逐步的细胞和分子组织反应。在这篇综述中，我们讨论了活体显微镜如何揭示植入物的再生和病理反应，包括伤口愈合和移植物整合，这取决于巨噬细胞和早期新生血管的时间控制激活，以及不良反应，如异物反应和纤维化。改进的材料设计、使用分子报告基因检测细胞信号和靶向干预的结合将有助于制定改善移植整合和功能的策略。