Chirality Maintenance, Shadow Sector Leakage, and the Mitochondrial Basis of Enantiomeric Pharmacology : Paper XIV in MEF Series

Paper XIII of the Master Equation Framework (MEF) establishes that the Z₂ orbifold identification on T²/Z₂ — the mathematical operation responsible for three fermion generations, mock modularity, and the cristae Casimir cavity structure — is also the mechanism for biological chirality selection, with the Zwegers shadow corresponding to the D-amino acid mirror sector. This paper takes that identification as a premise and develops its consequences for medicine. The central thesis is: biological homochirality is not a historical boundary condition but an actively maintained state. The maintenance mechanism is the local zero-point field (ZPF) spectral density within mitochondrial Casimir cavities, parameterised by an effective biological modular parameter τ₂ᵇⁱᵒ. When cristae geometry degrades, τ₂ᵇⁱᵒ decreases, the Zwegers shadow amplitude grows, and measurable chirality signatures appear across four domains: (i) Protein racemisation: D-aspartate accumulation in long-lived proteins correlates with tissue-specific mitochondrial health, not merely chronological protein age. (ii) The Warburg chirality cascade: degraded cristae geometry weakens enzyme enantioselectivity, producing a positive-feedback loop that deepens the Warburg metabolic trap. (iii) Enantiomeric pharmacology: the potency ratio of enantiomeric drug pairs is a variable function of the receptor tissue's mitochondrial state, not a fixed pharmacological constant. (iv) Neuronal chirality and mental health: a dual degradation mechanism — production deficit (Paper XIII, BH₄ depletion) plus reception deficit (reduced receptor enantioselectivity) — converges on treatment resistance. Eight testable predictions (P-XIV-1 through P-XIV-8) are presented, each with a proposed experimental design, expected outcome, and explicit falsification condition. Every prediction is testable with existing analytical methods. The paper's value is not contingent on all eight being confirmed; even partial confirmation would reshape the relevant field. The framework invites experimental refutation as the most productive form of engagement. Keywords: chirality maintenance, mock modular forms, Zwegers shadow, D-amino acids, racemisation, enantiomeric pharmacology, mitochondrial dysfunction, Casimir Tissue Resonator, Warburg effect, treatment resistance, photobiomodulation, Spinᶜ holonomy Rigour convention. Every claim is classified: Rigorous (established, peer-reviewed, replicable), Derived (follows from rigorous premises by explicit reasoning), Motivated (plausible, mechanistically consistent, not yet evidenced), or Gap (identified absence requiring further work).