PfCM increases RBC echinocytosis and intracellular ROS. RBCs incubated in control medium or PfCM overnight were imaged using scanning electron microscopy (AMRAY 1810×, 2000× total original magnification) and assessed based on (A) morphology scores and (B) percentage echinocytes (n = 7). RBCs incubated in control medium or PfCM overnight were washed after incubations and stained with DCFDA to quantify intracellular ROS using flow cytometry. Representative flow cytometry histogram shown (C) and bar graph of ROS fold change compared with the control (D); n = 4. Mean ± standard error of the mean denoted by error bars. A 1-way paired t test was used to analyze the data. ∗P < .05; ∗∗P < .005; ∗∗∗P < .0005.