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Chapter 8: From Resistance to

Revolution – Building the Immune-
Compatible Biologic Ecosystem

8.0 – Introduction: The Long Road from
Disruption to Adoption

Every revolution in medicine begins with discomfort—not
just in the body, but in the system.

For decades, biologic therapies have been among the most
sophisticated drugs humanity has ever developed.
Engineered proteins that target disease at its root,
personalized down to molecular pathways. They’ve
transformed treatment paradigms for autoimmune disease,
cancer, rare conditions, and beyond.

But they’ve also brought with them a quiet crisis:
tolerization—the immune system’s inevitable rejection of
the very therapies designed to help. A biologic might work
brilliantly in the lab or early in treatment, only to fail
months later as antibodies neutralize its effect. This isn’t
rare. It’s built-in. And for too long, it was treated as
acceptable collateral.

The earlier chapters of this book documented that
problem—scientifically, clinically, and economically. We
explored the biologic lifecycle, the cost of switching
therapies, and the structural incentives that favored churn
over durability.

We then examined the technologies rewriting that story:

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