Fermentation-Induced Changes in Phytochemical Composition and Pharmacological Activities of Zingiberaceae Plants: Insight from in vitro and in vivo Studies

The Zingiberaceae family has long been used in traditional medicine due to its rich array of secondary metabolites. However, its low bioavailability, limited stability in its native form, degradation during digestion, and poor solubility in water all restrict its absorption in the human body. Fermentation represents an effective biotechnological method for modifying the phytochemical composition and potentially enhancing its pharmacological effects. This study aims to explore the impact of fermentation on Zingiberaceae, focusing on the alteration of phytochemical profiles and the enhancement of pharmacological activities. Articles were sourced from the Scopus and PubMed databases and filtered for publications between 2015 and 2025; there were 2 articles that were electronically removed before screening due to duplication, yielding 62 articles. These articles were then further screened based on titles, abstracts, and full texts, resulting in five relevant studies. Fermentation was found to improve the phytochemical profile, influenced by the microbial strains used and the physicochemical properties of the phytochemicals. The fermentation process enhanced the stability of compounds, such as converting 6-gingerol to 6-shogaol and transforming glycosides into aglycones, which are more easily absorbed by the body. Additionally, fermentation increased phenolic and flavonoid content, accompanied by enhanced antioxidant and anti-inflammatory activities. Pharmacologically, in vitro studies showed that fermented extracts modulate cytokine signaling pathways in immune cells while enhancing anti-aging properties and skin barrier protection. Meanwhile, in vivo studies demonstrated improvements in metabolic regulation and neuroprotective effects in cognitive disorders. Further mechanistic investigations are needed to clarify the pathways through which fermentation influences the behavior of phytoconstituents and their pharmacological performance. This review provides an overview of preclinical fermentation studies on Zingiberaceae plants, both in vitro and in vivo, with a focus on their phytochemical composition and effectiveness in enhancing pharmacological activity.