Application of fermented Chinese herbal medicines in food and medicine field: From an antioxidant perspective

Fermentation, an ancient production method ingrained in the history of human civilization, has been extensively employed to enhance the biological activity of Chinese herbal medicine (CHM), notably its antioxidant capacity. Higher antioxidant capacity of fermented CHM (FCHM) is evidenced by elevated free radical and reactive oxygen species scavenging capacity, increased expression of antioxidant enzymes, and activated Nrf2 signal pathway, making it widely applicable in the field of food and medicine. In this study, the scientific value of antioxidant properties of fermented herbs in the food and medicine field was explored. We comprehensively reviewed the techniques used in fermenting CHM, the microorganisms involved, and the benefits conferred by fermentation. Next, we delved into the functional and sensory advantages of incorporating FCHM in food, mainly focusing on its antioxidant properties, as well as its therapeutic role in diverse diseases including neuroinflammation, colitis, cardiovascular disease, systemic inflammation, diabetes, and cancer. Finally, we illustrated the application and prospective advancements of fermented herbs in the domain of synthetic biology and nanoparticle technology. This review is of great significance in the development of herbal medicine formulations exhibiting elevated antioxidant activity and in advocating for the integration of FCHM in the realms of the food industry and medicine.